Model withdrawal form


complete and return this form if you wish to withdraw from the contract

To: 
Autoteile di Francesco 
Owner: Claudio di Francesco
Kapellenweg 4
DE-73466 Lauchheim
Telefax: +49 (0) 7363-9193-02 
EMail: info@autotechnik24.de

- I/We (*) hereby give notice that I/We (*) withdraw from my/our (*) contract of sale of the following goods (*)/for the provision of the following service (*)

Order- or invoice-number: .......................................


Ordered good(s):

    ....................................................................................................................

    ....................................................................................................................


....................................................................................................................



Ordered on .......................................    Received on  .......................................


Name and adress oft he customer(s)

    Name:   .................................................

    Street: .................................................

    Zip-Code/City:...........................................

    Phone..: ................................................

    E-Mail:  ................................................


Date: ......................................


Signature oft he customer(s)                     ..............................................
(only if this form is notified on paper)




(*)  Delete as appropriate.