Model withdrawal form
(complete and return this form only if you wish to withdraw from the contract)
AIMPLIFY Distribution Inc.
Fax: +49 3632 828234
- 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),
(*) Delete as appropriate.