withdrawal form
(complete and return this form only if you wish to withdraw from the contract)
To:		HML Fetish, Inhaber Detlef Moller
street and housenumber		Neukirchstr. 18
land/city		DE-28215 Bremen
Tel.:		+49 421 371430
Fax:		+49 421 374953
e-Mail:		info@hm-leder.de
I/We (*) hereby give notice that I/We (*) withdraw from my/our (*) contract of sale of the following goods (*)/for the provision of the following service (*),:
ordered on:
received on:
sender of withdrawal:
Name of consumer(s):
Address of consumer(street + number):
Address of consumer(ZIP, city and land):
Date		Signature of consumer(s) (only if this form is notified on paper)
___________ (*) Delete as appropriate.