Himalaya Textilhandels GmbH
Röthbargweg 2b
22145 Braak
I/we (*) hereby revoke the contract concluded by me/us (*) for the purchase of the following goods (*)/the provision of the following service (*):
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Ordered on (*)/received on (*): _________________________________________
Name of consumer(s): __________________________________________
Address of the consumer(s): ________________________________________
Signature of the consumer(s) (only if notification is on paper)
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Date ____________________________
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(*) Delete as appropriate.