Revoke Contract

Withdrawal form

If you would like to cancel the contract, please fill out this form and send it back.

An

Heavy - Tuned GmbH
Seilschlagstr. 4 - 6
31311 Uetze Germany

Fax:
051479749437 E-mail: [email protected]

I hereby cancel (*) the contract I have concluded for the purchase of the following goods (*)/the provision of the following service (*)

_______________________________________________________

_______________________________________________________

Ordered on (*) ____________/received on (*) __________________

________________________________________________________ Name
of consumer

________________________________________________________ Consumer
's address

________________________________________________________ Consumer's
signature (only if notified on paper)

_________________________ Date

(*) Delete where not applicable