Model return form

(If you want to withdraw from the contract, please fill out this form and send it back.)

At :
Keyk
Musterman
Römerstr 13
D-50996 Köln
Email info@keyk.de

Hereby give notice (s) I / We (*) withdraw from my / our (*) contract entered into for the purchase of the following goods (*) / provision of the following service (*)

_____________________________________________________

Ordered on (*) / received on (*)

__________________

Name / consumer (s)

_____________________________________________________

Address of / consumer (s)


_____________________________________________________

Signature / consumer (s) (only for message on paper)

__________________

Date

__________________


(*) Delete where inapplicable.