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Withdrawal form

If you want to cancel the contract, then please fill out this form and send it back to:

Michael Wirges Tischlermeister
Gewerbegebiet Bitzen 7
53804 Much
Germany
Telefax: 00(49) 2247 / 75 84 08
E-Mail: office@wooden-blocks.co.uk

Hereby I / we (*) give notice that I / we (*) revoke from my / our (*) concluded contract for the purchase of the  following products (*) / provision of the following services (*):

___________________________________ ___________________________________
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Appointed on (*) / received on (*) ___________________________________

Name of person / consumer (*) ___________________________________

Address of person / consumer (*) ___________________________________

Signature of / consumer (*) ___________________________________

Date_____________________

(*) Delete as applicable

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