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Cancellation form

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

Attention (Lace Go,

I/We (*) hereby notify you (*) of my/our (*) withdrawal from the contract for the sale of the following goods (*)/services (*):

Ordered on (*)/received on (*) :

Name of consumer(s):

Address of consumer(s):

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

(*) Delete as appropriate

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