model termination form Only complete and return this form if you wish to terminate or withdraw the agreement. product(s)*I'm informing you with this form that I wish to withdraw the agreement concerning the sale of the following goods date of purchase* change product was received on* change your information preamble* Mr Mrs Miss full name* address 1* address 2 zip code* city* state country* email address*Check you have given the correct email address, otherwise we will not be able to react. You will receive confirmation of receipt. telephone number*Providing us with a telephone number and the times you can be contacted, this will allow us to assist you faster. Please, leave this field empty. Send