Model Withdrawal Form

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

To SoundCloud Ltd.
Rheinsberger Str. 76/77
10115 Berlin, Germany
Fax: +49 30 577 098 860, contact@soundcloud.com:

I/We [*] hereby give notice that I/We [*] withdraw from my/our [*] contract of sale of the following goods [*]/for the provision of the following service [*],
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.

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