MODEL CANCELLATION FORM

Terms and Schedules

1. (Complete and return this form only if you wish to withdraw from the Agreement)
2. To JustHostMe Limited
3. - 11 Oatlands, Swindon, Wiltshire, SN5 6AU, United Kingdom
4. - support@justhostme.co.uk
5. I/We [*] hereby give notice that I/We [*] cancel my/our [*] contract for the supply of the following service [*],
6. Ordered on [*],
7. Name of consumer(s),,
8. Address of consumer(s),
9. Signature of consumer(s) (only if this form is notified on paper),
10. Date
11. [*] Delete as appropriate