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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 *
Captcha *