(complete and return this form only if you wish to withdraw from the contract)

Automotive Konzepte OHG
Nürburgring Boulevard 2
53520 Nürburg

I/We (*) hereby give notice that I/We (*) withdraw from my/our (*) contract of sale of the following goods (*)

Ordered on (*)/received on (*)

Name of consumer(s)

Address of consumer(s)

Signature of consumer(s) (only if this form is notified on paper)


(*) Delete as appropriate.