MODEL CANCELLATION FORM

Complete and return this form only if you wish to cancel the contract.

To: NAUTIC FORECASTING LTD
20 Wenlock Road, London, N1 7GU
Email: billing@antistatic.exchange

I/We (*) hereby give notice that I/We (*) cancel my/our (*) contract for the
supply of the following service:

Antistatic Pro subscription

Ordered on: ____________________

Name of consumer(s): ____________________

Address of consumer(s): ____________________

Account email (to help us identify the subscription): ____________________

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

Date: ____________________

(*) Delete as appropriate.