(If you want to revoke the contract, please fill out this form and send it back.)

An

Alt and Shirazi GbR

Teckstr. 66

70190 Stuttgart

info@yeyeye.de

I/we (*) hereby revoke the contract concluded by me/us (*) for the purchase of the following goods (*) / the provision of the following service (*)

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Ordered on ___________________ (*)/received on _______________________(*)

Name of consumer(s) ______________________________________

Address of the consumer (s)

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Date:________________

Signature of consumer(s):___________________________________________

(only on message on paper)

(*) Delete as appropriate