Withdrawal

To
Vienna Dog Shop
Fa. Brigitte Holzmann
Grenzackerstrasse 7/ 19/ R01
1100 Vienna, Austria


info@vienna-dog-shop.at
Fax: 0043 1 9294470


I/We hereby give notice that I/We withdraw my/our contract of sale of following goods/for the supply of the following service:

(name of the product, if applicable order number and price)

Ordered on:
Received on:


name and address of the consumer(s):
Name of consumer(s):
Address of consumer(s):


_____________________________________________________
date and signature of the consumer(s) (only if this form is notified on paper)
osCommerce