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Revocation form
(If you want to cancel the contract, please print out this form and return it filled out).

To
b.riz Vertriebs KG
Bauernmarkt 11-13
1010 Vienna

hb @ anita-muenz.at

I / we (*)

hereby revoke the contract concluded by me / us (*) for the purchase of the following goods:



OrderNr.:
Ordered on:
Received on:

Name of the consumer(s) (*):

Address of the consumer(s) (*):

Signature of the consumer(s) (*)

Date:

(*) Delete where inapplicable.