Cancellation form

Cancellation form

If you wish to cancel the contract, please fill out and return this form.

To

Licensix GmbH
Willi-Plappert-Straße 4
31137 Hildesheim
Germany

Phone: 0800 330 37 49
E-mail: shop@licensix.com

Herewith I/we (*) 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 (*) __________________

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Name of the consumer(s)

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Address of consumer(s)

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Signature of consumer(s) (only in case of paper communication)

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Date

(*) Delete as applicable