Cancellation form

If you wish to revoke the contract concluded with tosag Engineeirng ag,
then please fill out this form and return it to us.

tosag Engineering ag
Fuchsweidweg 12
ch-4852 Rothrist
E-mail: philipp.schaerer@tosag.ch
Fax: +41 62 794 14 58

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

Brief description:

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Auftragsnummer: _______________________________________________________

First name: _______________ Last name: _______________________

Street, house number: _______________________ postcode, city ____________________

Place, date _____________________ Signature _________________________