Cancellation Form

Name *

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Email Address *

(Enter a valid email address)

Contact Number *

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I/We hereby give you notice that I/We cancel my/our contract for the sale of the following goods/for the supply of the following order: *

I/We confirm the order cancellation request

(In accordance with the terms & conditions of supply)

Order Number *

Date Order Received *

(Format DD/MM/YYYY)

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