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name
address
city zip

Fondazione Telethon ETS
Via Varese 16b
00185 Roma

city, 2026-07-22

Oggetto: Disdetta contratto

Il sottoscritto name, nato il birthdate, residente in Indirizzo: address Città: city, C.A.P: zip, con i seguenti dati identificativi relativi al donatore:
Email: email

In qualità di donatore regolare, comunico la mia volontà di revocare la donazione regolare in oggetto a partire.

Cordiali saluti,

name

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