Cancellation Form

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

To Pillbox38 (UK) Limited t/a Totally Wicked of Stancliffe Street, Blackburn, Lancashire BB2 2QR and :


I/We [*] hereby give notice that I/We [*] cancel my/our [*] contract of sale of the following goods:



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

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