…………………………………………….
Consumer’s first and last name
…………………………………………….
Consumer’s address…………………………………………….
Email address / phone number
Declaration of withdrawal from the contract
I, …………….. …………………………….., hereby inform you of my withdrawal from the contract of sale of the following goods:
…………………………………….. …………………………………
Date of receipt of the goods: …………………………………………….
Order number: …………………………………………….
…………………………………. …………
Consumer’s signature (only if sent in paper form)
Date: …………………………………………….