Cancellation Form

(Complete and return this form only if you wish to withdraw from the contract)  Please copy, paste, fill in and email it to –

To RGH Supplies Limited

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),