The following statutory model form is provided as required by law. You do not need to use this form. The electronic withdrawal function on this website is the recommended method.
IMPORTANT: The address appearing in the form below is an address for sending a withdrawal declaration only.
It is NOT a product return address. Do not send products or return parcels to this address.
If a product must be returned, the appropriate authorised return address will be provided separately after we receive your withdrawal request.
Model Withdrawal Form
If you wish to withdraw from the contract, complete and send this form:
To:
E-Commerce Sekip Topcu
Proprietor: Sekip Topcu
Disanvita
Bürgermeister-Grünzweig-Str. 1
67059 Ludwigshafen
Germany
Email: e-commerce@disanvita.com
I/We hereby give notice that I/we withdraw from the contract concluded by me/us for the purchase of the following goods:
Goods:
Ordered on / received on:
Name of consumer(s):
Address of consumer(s):
Signature of consumer(s):
Date:
Order number (if available):