If you wish to cancel the contract, please fill out the following form and send it back.
Address for returns:
Statement clo GmbH
Philipsstrasse 15
52068 Aachen
Germany
Business address: (Not for returns!)
Statement clo GmbH
Rheinpromenade 11
40789 Monheim am Rhein
Germany
Phone: +49 2253-1859057
Email: support@statement-clo.de
I/we (*) hereby revoke the contract concluded by me/us (*) for the purchase of the following goods:
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- Ordered on ______________________ / received on ______________________
- Order number: _______________
- First name / last name of the consumer(s) _______________________ / ______________________
- Address of the consumer(s)
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- Signature of the consumer(s) / Date (only if notification is on paper):
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(*) Delete as appropriate.
