Model Withdrawal Form

Example of a cancellation form

(If you wish to cancel the contract, please fill out and return this form).
To
Zippo GmbH
Return zippo.de
Groendahlscher weg 87
46446 Emmerich aan de Rijn
Germany
Fax +49 (0)2822 600 650
E-mail

I/we (*) hereby revoke(s) the agreement(s) concluded by me/us (*) regarding the purchase of the following goods (*)/the provision of the following service (*).
goods (*)/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 communication on paper)

Date
(*) Strike out what is not applicable.

Send your revoked goods exclusively to the following address: 

Yusen Logistics Co Zippo Retoure
Halle M
Marseiller Str. 14-16
47229 Duisburg
Germany