Withdrawal

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

Movisi GmbH

Leobenerstr 104
70469 Stuttgart
Germany

E-Mail: [email protected]

Withdrawal

Details to identify the contract

e.g. order number, product name or order date

Name of consumer(s)

Firstname

Lastname

Electronic means of communication for us to send you the acknowledgement of receipt of your withdrawal

Electronic means of communication (email address)

Privacy I have read the privacy notice.

* required