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Revocation form

Attention! (only fill in and resend if you want to rescind on your purchase).

To Assyriological Centre Georges Dossin
Jubelpark 10
1000 Brussel



hereby announce that I / we cancel our agreement regarding the sale of this/these

Order date: *
Delivery date: *
Ref. number order: *
Articles ref.: *
Name /names buyer(s): *
Adress: *
Country: *
IBAN: *
BIC:
Email: *
Date: *
ik ben geen robot:: *
9 + 4 =


You will receive a confirmation after receipt of this form.