To Pobworks Ltd, Westleigh, Carnkie, Redruth, Cornwall TR16 6RZ:

​

I/We [*] hereby give notice that I/We [*] cancel my/our [*] contract for the 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

​

​