Adsamm® - Quality since 2005

Revocation Form

Adsamm Werbe- und Marketing GmbH
Laimburggasse 6
8010 Graz

by fax to: +43 316 680 297
or by email to:

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)


* Please remove if not applicable.