Model withdrawal form (Complete and return this form only if you wish to withdraw from the contract.) To: Uptimo support@uptimo.local Full address: https://uptimo.de/en/legal/imprint I hereby give notice that I withdraw from my contract for the provision of the following service: ________________________________________ Ordered on / contract concluded on: ________________________________________ Name of consumer: ________________________________________ Address of consumer: ________________________________________ Date: ________________________________________ Signature (only if this form is submitted on paper): ________________________________________