MODEL WITHDRAWAL FORM

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

To

Boneka Tradition Claudia Hillesheim

Falkenecksweg 39

35619 Braunfels

claudia.hillesheim@web.de

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 (*),

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Ordered on ___________________ (*)/received on _______________________(*)

Name of consumer(s) ______________________________________

Address of consumer(s)

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(*) Delete as appropriate