(If you want to withdraw from the contract, please fill out this form and send it back)
To
NUC Electronics Europe GmbH
Am Kronberger Hang 3
65824 Schwalbach am Taunus
Telefax: +49 (0)6196 950 2699
info@nuc-eu.com
I/we (*) hereby give notice that I/we (*) withdraw from 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)
_________________________________
_________________________________
_________________________________
Date:________________
Signature of consumer(s):___________________________________________
(only if this form is notified on paper)
(*) Delete as appropriate