Cancellation Form

To the attention of Coco & Minou
4 Rue Juliette Nevouet
60000 Goincourt
Beauvais
France

Email: coco.and.minou@gmail.com

I / We (*) notify you (*) by the
presents my/our (*) withdrawal from the contract
for the sale of the property (*) / for the service
of service (*) below

- Ordered on (*) / received on (*)
- Name of the consumer(s)
- Address of the consumer(s)
- Signature of the consumer(s) (only)
in case of notification of this form on
paper)
- Date

(*) Delete as appropriate.