Fillable Widerrufsformular DSV Solutions GmbH TMH Lager / Tor

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Widerrufsformular DSV Solutions GmbH TMH Lager / Tor

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DSV Solutions GmbH
TMH Lager / Tor 210
Einsteinallee 12
77933 Lahr / Schwarzwald
oder per Fax an: +49 89 4161430 80
oder per E-Mail an: support@mobilityhouse.com
Widerrufsformular
(Wenn Sie den Vertrag widerrufen wollen, dann füllen Sie bitte dieses Formular aus und senden Sie es zurück.)
Hiermit widerrufe(n) ich
/wir (*) den von mir/uns (*) abgeschlossenen Vertrag über den Kauf
der folgende
n Waren (*)/die Erbringung der folgenden Dienstleistung (*):
Bestellt am (*)/erhalten am (*)
Name des/der Verbraucher(s)
Anschrift des/der Verbraucher(s)
Bestellnummer
(*) Unzutreffendes bitte streichen.
Unterschrift des/der Verbraucher(s) (nur bei Mitteilung auf Papier)Ort, Datum
X
Konto-Nr. / IBAN
Kontoinhaber (Name, Vorname)
BLZ / BIC
Die Rückerstattung der Zahlung soll auf folgendes Konto erfolgen:
Kreditinstitut mit Ortsangabe
TMH 2018.v1-de
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Widerrufsformular DSV Solutions GmbH TMH Lager Tor

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Completed 26 January 2021

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