Cancellation Form

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

To Laza Plumbing & Heating Merchants Ltd
0208 443 3264 / 0208 443 3265

I/We [*] hereby give notice that I/We [*] cancel my/our [*] contract of sale of the following goods [*]/for the supply of the following service [*],

Ordered on [*]/received on [*],

Name of consumer(s),

Address of consumer(s),

Signature of consumer(s) (only if this form is notified on paper),


[*] Delete as appropriate