Revocation form

If you would like to revoke a contract concluded on our online site, please print out and fill in the model form below, and send it back to us.

Alternatively you may download this form as PDF file.



To

LimeSurvey GmbH
Barmbeker Str. 7a
22303 Hamburg / Germany
This email address is being protected from spambots. You need JavaScript enabled to view it.


By this I/We (*) revoke the concluded contract regarding the following bought goods / bought services

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Order date (*)/Performance date (*) ..........................................................................

Consumer name ..........................................................................

Consumer address ..........................................................................


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Comsumer signature (only if submitted on paper)



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Date

(*) Strike non-applicable texts