Withdrawal

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

To

4 Wheel Parts GmbH
Ralf Janke
Richard Wagner Str. 23
71701 Schwieberdingen
Germany

Fax: +49 (0)3212 - 1791965
E-Mail: myjeep@4wp.de

Withdrawal
Note: Delete as appropriate.
Name of consumer(s)
   
Address of consumer(s)
Your e-mail address, to immediately confirm the receipt of the withdrawal
Withdrawal date
Privacy
 

* required