Cancellation Form

Complete and return this form only if you wish to withdraw from the contract

To WMI Simpsons Ltd
020 8343 7090
sales@wmisimpsons.co.uk justin@wmisimpsons.co.uk

I/We [*] hereby give notice that I/We [*] cancel my/our [*] contract of sale of the following goods [*]/for the supply of the following service [*],

Ordered on [*]/received on [*],

Name of consumer(s),

Address of consumer(s),

Signature of consumer(s) (only if this form is notified on paper),

Date

[*] Delete as appropriate