Withdrawal form

Complete and return this form only if you wish to withdraw from the contract.

Gerstendörfer GmbH
Rennmühle 3
91126 Schwabach
Germany
Phone: +49 9122 92 68 0
Fax: +49 9122 92 68 20
Email: info@gerstendoerfer-blattgold.de

I hereby give notice that I withdraw from my contract of sale of the following goods:

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Goods ordered on: ...........................................

Goods received on: ...........................................

Name and address of consumer:

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Signature of concumer:

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Date:

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