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Rescission Form

If you want to cancel the order, then please fill the form below and send it to us.

Product nummber(s)*

Date de la commande*

Recieved date

Name of person / consumer (s)

Sexe*

Prénom*

Nom de famille*

Address of person / consumer (s)

Rue*

Ville*

Pays*

Adresse e-mail*

Client-No.*

Invoice No.*

Votre message

Revocation date*

Code de sécurité*

* Informations nécessaires

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