Online Cancellation Form

If you wish to cancel the contract, please complete the form and return it to

Eberhard Göbel GmbH & Co. KG
Im Lehrer Feld 44
89081 Ulm / Germany
Fax: +49/731-140-13-10
E-Mail: info@euroschirm.com


All fields marked with * are compulsory

	If possible, please name the order, invoice or delivery note no. This will help us to process your revocation more quickly.
Order no.:
invoice no.:
delivery note no.:
Quantity / Article designation:	/
Quantity / Article designation:	/
Quantity / Article designation:	/
Quantity / Article designation:	/
Goods ordered on*:
Goods received on:
Remark:
Title*:	please select Mr Mrs
First name*:
Last name*:
Street / no.*:
Postal code / Place*:
Country:
	Your e-mail address is mandatory in order to confirm the receipt of your revocation.
Your e-mail address*:
Date of revocation*:
Security code