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(If you wish to withdrawn from the contract, please complete and return this form.)


Komar Products GmbH & Co. KG
Carl-Jordan-Straße 13
83059 Kolbermoor

I/we (*) hereby withdraw from the contract which I/we (*) concluded for the purchase of the following goods (*)/ rendering of the following service (*)
Ordered on (*)/received on (*):

Name of consumer/s:

Address of consumer/s:


Signature of consumer/s (only if notification is submitted in paper form):


(*) Delete as appropriate.