Model cancellation form

To

myRobotcenter United Kingdom

myRobotcenter GmbH

Hauptstrasse 25

6840 Götzis

E-mail: office@myRobotcenter.co.uk

I / We [*] hereby give notice that I / We [*] cancel my/our [*] contract of sale of the following goods [*]/for the supply of following service [*]:

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Ordered on [*] / received on [*],: .................................................

Name of consumer(s),:...............................................................

Adress of consumer(s),:..............................................................

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Signatur of consumers(s)

(only if this form is notified on paper)

Date: ........................................................

[*] Delete as appropriate