If you wish to cancel the contract, please fill out and return this form.

To

Wiresoft AG
Oberneuhofstrasse 5
CH-6340 Baar

Email: [email protected]

I/we (*) hereby revoke the contract concluded by me/us (*) for the purchase of the following goods (*)/provision of the following service (*)

_______________________________________________________

_______________________________________________________

Ordered on (*) ____________ / received on (*) __________________

________________________________________________________Name of the consumer(s)

________________________________________________________Address of the consumer(s)

________________________________________________________Signature of
consumer(s) (only in case of paper notification)

_________________________Date

(*) Delete where not applicable