Model withdrawal form

If you wish to withdraw from the contract, complete and return this form. Use of this form is optional.

To

Geckox, proprietor Klaus Wegner, Korbitzer Str. 21a, 01662 Meissen, Germany. Email: service@geckox.shop. Fax: +49 3521 407635.

Notice

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 (*): ____________________

Details

Ordered on (*) / received on (*): ____________________
Name of consumer(s): ____________________
Address of consumer(s): ____________________
Signature of consumer(s) (only if submitted on paper): ____________________
Date: ____________________
(*) Delete as appropriate.