Cancellation Form

MIOGA Warenhandel & Service GmbH

Königsbrücker Str. 124
01099 Dresden

eMail: support@mioga.de

Revocation *

Hereby I/we withdraw the Treaty concluded by me/us on the purchase of the following goods / provide the following services:

Ordered on *

Goods were recieved on

Title

Forename *

Surname *

Address 1 *

Address 2 *

Country

Email *

Revocation date *

20.03.2023

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