Model Withdrawal Form

This form may be completed and returned to withdraw from the contract. Another unequivocal statement of withdrawal may be sent instead. Use of this form is not required.

To:
BARBARA et Co.
Barbara Roth
c/o IP-Management #12433
Ludwig-Erhard-Str. 18
20459 Hamburg
Germany
Email: support@barbaraetco.com

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

____________________________________________________________

Ordered on (*) / received on (*): ____________________________

Name of consumer(s): _________________________________________

Address of consumer(s): ______________________________________

____________________________________________________________

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

____________________________________________________________

Date: ______________________

(*) Delete as appropriate.

The order number may be added voluntarily to help identify the order. A reason, bank details, or a signature for an electronic statement is not required.