Model Cancellation Form

Complete and return this form only if you wish to cancel a contract where a statutory right to cancel applies.

To:

Elizangela Lopes trading as Inner Trinity

68 Cornhill

London

EC3V 3QX

United Kingdom

I hereby give notice that I wish to cancel my contract for the following service:

Service: ______________________________

Date the contract was entered into: ______________________________

Name of consumer: ______________________________

Address of consumer: ______________________________

Signature of consumer: ______________________________

(only if this form is submitted on paper)

Date: ______________________________