Withdrawal

Complete and return this form only if you wish to withdraw from the contract.

To

A.u.S. Spielgeräte GesmbH

Scheydgasse 48
1210 Wien
Austria

Fax: +43 (1) 2716600-75
E-Mail: shop@coinoperatorshop.com

Withdrawal
Note: Delete as appropriate.
Name of consumer(s)
 
Address of consumer(s)
Your e-mail address, to immediately confirm the receipt of the withdrawal
Withdrawal date
Privacy I have read the privacy notice.
 

* required

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