Adsamm® - Quality since 2005

Revocation Form

To
Adsamm.com
Adsamm Werbe- und Marketing GmbH
Laimburggasse 6
8010 Graz

by fax to: +43 316 680 297
or by email to: officenospamplease@nospampleaseadsamm.com

I/ We* revoke the concluded me/ us contract for the purchase of the following products/ the provision of the following service*.

 


Order date*/ received date*


Name of the consumer


Address of the consumer


Signature of the consumer (only required for communication on paper)


Date

* Please remove if not applicable.