Model Cancellation Form for consumer customers

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

To: Securitatem Installations Limited

Unit 5, Roebuck Business Park, Ashford Road, Kent, ME17 1AB

Telephone: +44 (0) 203 746 2214

I/We [*] hereby give notice that I/We [*] cancel my/our [*] contract of sale of goods and services relating to your order number [*],

Ordered on [*]/received on [*],

Name of consumer(s),

Address of consumer(s),

Signature of consumer(s) (only if this form is notified on paper),

Date

[*] Delete as appropriate

Securitatem Installations