Cancellation form


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


To:
LUCA
Luca Vertriebs GmbH
Berliner Allee 65
64295 Darmstadt
GERMANY

Fax: +49 (0)6151 3975 111
or use our contact form

 

I hereby revoke the contract concluded by me for the purchase of the following goods.

 

- Ordered on/received on

 

- Customer Name

 

- Order Number

 

- Signature

 

- Date