Cancellation form
Sample withdrawal form
(If you want to revoke the contract, please fill out this form and send it back).
imima GmbH, Managing Director: Mr. Marvin Thoma, Schwarzäckerstr. 41, 82178 Puchheim, Phone: +49(0)89 54662292, E-Mail: info@imima.de
- I/we (*) hereby revoke the contract concluded by me/us (*) for the purchase of the following goods (*)/the provision of the following service (*)
- Ordered on (*)/received on (*)
- Name of the consumer(s)
- Address of the consumer(s)
- Signature of consumer(s) (only in case of paper communication)
- Date(s)
(*) Delete where not applicable.