Sample Revocation Form

(If you wish to cancel the agreement, please complete and return his form).

Sample Revocation Form

To:
TIER Mobility GmbH,
c/o WeWork,
Eichhornstraße 3,
10785 Berlin
Germany

Tel: +49 030 / 568 38651,
e-mail: info@tier.app

Revocation
I/we (*) hereby revoke the agreement concluded by me/us (*) for the purchase of the following goods (*)/the provision of the following service (*):

Order No:

Ordered on (*)/received on (*):

Consumer Name:

Consumer address:

Consumer Signature
(only for paper notices)

Date:

(*) Delete as applicable.