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Model Cancellation Form

(complete and return this form only if you wish to cancel your contract)

— To

Post: [INSERT RELEVANT ADDRESS TO RECEIVE THE CANCELLATION]

Email: [INSERT RELEVANT EMAIL ADDRESS TO RECEIVE THE CANCELLATION]

— I/We [*) hereby give notice that I/We [*] cancel my/our [*] contract of sale of the following goods [*]/for the provision of the following service [*],

— Ordered on [*]/received on [*],

— Name of consumer(s),

— Address of consumer(s),

— Signature of consumer(s) (only if this form is notified on paper),

— Date

[*] Delete as appropriate.