Model Cancellation Form

To Mercedes-Benz Grand Prix Limited (trading as Mercedes-AMG Petronas Formula One Team), with registered address at Operations Centre, Brackley, Northamptonshire, NN13 7BD and company number 00787446 [and e-mail address]:

I/We [*] hereby give notice that I/We [*] cancel my/our [*] contract for the sale of the following goods [*]/for the supply 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