Withdrawal

Complete and return this form only if you wish to withdraw from the contract.

To

IPLS GmbH
Eugen Dener
Asbachstraße 10
77833 Ottersweier
Germany

E-Mail: kontakt@collecta.shop

Withdrawal
Note: Delete as appropriate.
Name of consumer(s)
   
Address of consumer(s)
Your e-mail address, to immediately confirm the receipt of the withdrawal
Withdrawal date
Privacy I have read the privacy notice.
 

* required