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 Model Cancellation Form

   - To: Tuinenga Kapsalons, Hoendiepskade 1, 9718 BD  Groningen - The Netherlands
   - E-mail: [email protected]

   - I / we [*] hereby give notice that I / we [*] cancel my / our [*] contract of sale of the following goods [*]




   - Ordered on (*)/ Received on (*)------------------------------------------


   - Name of consumer(s)------------------------------------------------------------------------------------------------


   - Addres consumer(s)-----------------------------------------------------------------------------------------------------------



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



   - Date---------------------------------------


   (*) Delete as appropriate




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