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Sample - Cancellation form

(If you wish to cancel the contract, please fill out and return this form).

To

Filafarm GmbH & Co. KG,
Wolfenerstr. 32-34, 12681 Berlin,
Fax number: +49 30 98358611
E-mail address: info@filafarm.de

- I/we (*) hereby revoke the contract concluded by me/us (*) for the purchase of the following goods (*)/the provision of the following service (*)_________________________________

Ordered on (*)/received on (*)

________________________________

Name of the consumer(s)

__________________________________

Address of the consumer(s)

_____________________________________________________________________

Signature of the consumer(s) (only in case of paper communication)

___________________

Date

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(*) Delete where inapplicable.