Model cancellation form

(If you want to cancel the contract, please fill out the form below and send it back to us)

— To COBRA Autozubehör-Vertriebsgesellschaft mbH, Alleestr. 15-19, 33818 Leopoldshöhe, service@cobra-sor.com, Fax: 05202-999250

— I / We[*] hereby give notice that I /We[*] cancel my/our [*] contract of sale of the following goods [*]/for the supply of the following service[*]

— Ordered on [*] / received on [*]

— Name of consumer(s

— Address of consumer(s)

— Signature of consumer(s) (only if this for is notified on paper)

— Date

[*] Delete as appropriate