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As a consumer you may withdraw from the purchase within 14 days. To revoke the contract, please fill out this form and send it back to us.

 

 

Revocation Form

 

To:

PURE GREEN GMBH
Gewerbepark 17
6426 Roppen

AUSTRIA

 

Fax: +43 5417 20127-30 

 

 

Declaration of Withdrawal

 

I / we* hereby revoke the contract concluded by me / us* for the purchase of the following goods* / the provision of the following service*

 

 

Ordered on/
received on*:


Your Name /
Name of the consumer(s)*:


Your Address /
Address of the consumer(s)*:

   

 

 

 Date:
 
      Your signature / Signature of the consumer(s)*


 

 
 
  *Please strike out inappropriate.

 

 

PURE GREEN