(If you want to cancel the contract, please fill out this form and return it.)

- An Astrid Bauchmüller Lederhosen e.K., Nebraskastr., 8 , 70806 Kornwestheim, info@mylederhosen.com, Germany, Fax: +49 (0) 7141 4877078

- I/we (*) hereby cancel the contract concluded by me/us (*) for the purchase of the following goods (*)/the provision of the following services (*)

- Ordered on (*)/received on (*)

- Name of consumer(s)

- Address of the consumer(s)

- Signature of consumer(s) (only for paper communication)

- Date

(*) Delete as applicable.