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Plant-Based Mosquito Spray

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Model Withdrawal Form

(If you wish to withdraw from the contract, you can fill out this form and send it back.)

Return address (for sending goods back):
Duft und Kultur
Tuchlauben 17
1010 Vienna

Send the withdrawal notice to:
Aschauer GmbH & Co KG
Friedrich Ludwig Jahn-Straße 5
4840 Vöcklabruck
Austria
Email: shop@duftundkultur.at

I/we (*) hereby withdraw from the contract concluded by me/us (*) for the purchase of the following goods:

Goods ordered: _______________________________________

Order number: _______________________________________

Ordered on: _______________ / received on: _______________

Name of consumer(s): ____________________________

Address of consumer(s): _________________________

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


Date: ___________________

(*) Delete as appropriate.