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Version status: In force | Document consolidation status: No known changes
Version date: 29 November 2022 - onwards
Version 2 of 2

Schedule 4, Part 2 Model cancellation form

Sections 103, 104, 106, and 115

[Complete and return this form only if you wish to cancel the contract.]

To [here the trader's name, geographical address and e-mail address are to be inserted by the trader]:

I/We [*] hereby give notice that I/we [*] cancel my/our [*] contract of sale of the following goods[*]/for the provision 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