Withdrawal form

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

Paolo Di Mitrio
Auf den Eichen 1
D-51674 Wiehl
Telefax: +49 2262 7616263
info@pdmcarparts.eu

I reject the contract I have concluded for the purchase of the following spare parts

_______________________________________________
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Ordinato presso ___________________ ricevuto il _______________________

Nome del cliente _______________________________________
Indirizzo del cliente
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Data:______________

Firma del cliente:_________________________________

(solo per la comunicazione su carta)