Model withdrawal form

To
Steinhartwatches
Steinhart Watches GmbH
Boschstr.6
86391Stadtbergen

by fax to: +49 (0)821 5433801
or by email to: info@steinhartwatches.de

I/ We^* revoke the concluded me/ us contract for the purchase of the following products/ the provision of the following service^*.

Order date^*/ received date^*

Name of the consumer

Address of the consumer

Signature of the consumer (only required for communication on paper)

Date

^* Please remove if not applicable.