Withdrawal from Contract

Form for withdrawal from a distance contract

(Fill out this form and send it back only if you wish to withdraw from the contract)

📄Notice of Withdrawal from the Contract

I/we hereby declare (*) that I/we hereby withdraw (*) from the contract for the purchase of these goods/the provision of these services (*):

(Describe the goods/services you are withdrawing from)

Order date (*)/ receipt date (*)

(Enter the date)

Name and surname of the consumer/consumers

(Enter your full name)

Address of the consumer/consumers

(Enter your full address)

Date

(Enter today's date)

Signature of the consumer(s)

(only if this form is sent on paper)

(Sign here if sending on paper)

⚠️

Please submit this form to withdraw from your contract.