Withdrawal form

Please fill in all fields. Fields marked with * are required.

If you want to cancel your order, please fill in the following form and send it to us.

To: DIDYMOS Erika Hoffmann GmbH, Alleenstr. 8/1, D-71638 Ludwigsburg, or by fax to +49 7141 975 71 26.

Withdrawal *

Note: Please delete where inapplicable and add your text.

Ordered on *

Received on

Consumer name

Title *

First name *

Last name *

Consumer address

Street *

Street no. *

ZIP Code *

City *

Country (only for consumers from abroad)

Your E-Mail required for immediate conformation of your withdrawal.

E-Mail *

Withdrawal date *