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Date (ie.

July 31, 2000)

BY REGISTERED MAIL

Recipient's Name
Recipient's Address

Dear Recipient's Name:

Re: Contract between Recipient's Name and Your Name dated Date of Contract
(the "Contract")

This letter will serve as my formal notification to you that I am hereby rescinding the
Contract effective immediately.

The reason for my action is Explain Reason(s) for Rescission (ie. the fundamental and
persistent inability of the video equipment to operate as per specifications agreed to, and
you inability to repair the same), as previously described in my correspondence to you.

Please advise me what arrangements you will make to pick up the Describe goods being
returned and when I can expect to receive a full refund for the purchase price of such
goods.

Yours truly,

Your Name

cc. Name of your Law Firm (Optional)

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