Model Withdrawal Form

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

To:
YoMa media
Owner: Marwa Alkzaz
Palm str. 2
47057 Duisburg
Germany
Email: info@velorashops.de

I/We () hereby withdraw from the contract concluded by me/us () for the purchase of the following goods :

— 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: