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Model Withdrawal Form: 
(Complete and return this form only if you wish to withdraw from the contract.)

To:

Lux by Jes
Schulstr. 34
64572 Büttelborn
Germany

Email: [luxbyjes@gmail.com](mailto:luxbyjes@gmail.com)

I/We () hereby give notice that I/We () withdraw from my/our (*) contract for the sale of the following goods:

 
Ordered on:
Month
Day
Year
Received on:
Month
Day
Year
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