Withdrawal form template

If you wish to withdraw from the contract, please fill out this form and send it back to:

biozoom services GmbH
Ziegelstrasse 17
34121 Kassel

Phone: 0561 52141-0
Fax: 0561 52141-11
E-Mail: info@biozoom.net

Hereby I withdraw the contract concluded by me/us for the purchase of the following goods:

  • Ordered the (*)/received the (*)
  • Customer’s name(s)
  • Address of the customer(s)
  • Customer’s signature (only for paper communication)
  • Date

_______________

(*) required fields