FORM OF CANCELLATION

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

To: Carol Ann Gvineria Consultancy, Unit 81908, PO Box 26965, Glasgow, G1 9BW, Scotland, UK UK Tel.: +44(0)7570076170, E-mail: support@thelisteninglabs.com

I/We [*] hereby give notice that I/We [*] cancel my/our [*] contract 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