Withdrawal form Complete and submit this form only if you wish to withdraw from your contract. Required fields are marked with an asterisk (*). To: deniz güvenlik DEĞİRMİÇEM MAH. SÜLEYMAN KURANEL CAD. ŞAFAK APT. NO: 31 B ŞEHİTKAMİL/ GAZİANTEP Name * Email address * Goods or service being withdrawn * Address Order or contract reference Order date Additional message Leave this field empty Send withdrawal request