Model withdrawal form

(Complete and return this form only if you wish to withdraw from the contract)


 



To:
KICKZ AG
Dr. Wilhelm-Kuelz-Strasse 11
D-15562 Ruedersdorf
Germany
Phone: +49 (0) 33 638 620 20
Fax: +49 (0) 33 638 2958 29
Email: logistik@kickz.com


 
 
I hereby give notice that I withdraw from my contract of sale of the following goods:
 
 
 
 
 
 
 
 

Ordered on / received on:
 
 
 

Name of consumer:
 
 
 

Address of consumer:
 
 
 

Signature of consumer: (only if this form is notified on paper)
 
 
 

Date: