Withdrawal form

If you want to revoke the contract, please fill out this form and send it back together with the items to:

Karen Cebe
Cozy Roots
Pfarrer-Holl-Weg 29
40489 Dusseldorf
Germany
Email: info@cosyroots.de

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

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Ordered on (*) ____________ / received on (*) __________________

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Name of consumer(s)

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Address of consumer(s)

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Signature of consumer(s) (only if notification is on paper)

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date

(*) Delete where not applicable