Cancellation form

 

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

- To Pramodan & Dinesh OHG, Westfälische Straße 169 a, 44309 Dortmund, Email address: info@bergsalz.com :

- 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 for paper notifications)
- Date

(*) Delete as appropriate.