Model withdrawal form

(complete and return this form only if you wish to withdraw from the contract)

— To 
OpenPandora GmbH
Schäffbräustr. 11
85049 Ingolstadt
Germany

— 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):





— Signature of consumer(s) (only if this form is notified on paper):



_______________________

— Date:


_______________________

(*) Delete as appropriate.


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