Cancellation Form

As a consumer, you can use the following form to exercise your right of revocation:
(*) First and Last Name
(**) Full Address
(***) Complete Date
(****) Required only for letter or fax

To
Otto Gerharz
Otto Ceramics
Industriestraße 12
53359 Rheinbach
Fax: +49 (0)2226 14802
Email: info@ottokeramik.com

Dear Mr. Gerharz,
I hereby revoke the contract concluded between us according to my order dated……….***
I received the ordered goods on………..***.
Name*
Signature****