Rescission Form

If you want to cancel the order, then please fill the form below and send it to us.

Product nummber(s)*

Date de la commande*

Recieved date

Name of person / consumer (s)

TEXT_FIRSTNAME*

TEXT_LASTNAME*

Address of person / consumer (s)

Rue*

Ville*

TEXT_COUNTRY*

TEXT_EMAIL*

Client-No.*

TEXT_INVOICE_NUMBER*

Votre message

Revocation date*

Code de sécurité*

* Informations nécessaires