Form of the declaration of withdrawal from the contract
MODEL FORM OF WITHDRAWING FROM THE AGREEMENT
(this form should be filled in and returned only if you wish to withdraw from the contract)
Addressee:
[seller’s identification details]
I hereby inform you about the withdrawal from the sales contract of the following products: …………………………………………………………………………………………………………
Order number: ………………………………………………………………………………….
The date of conclusion of the contract: …………………………………………………………………………………
Consumer’s name and surname: ………………………………………………………………………………………….
Consumer’s address: …………………………………………………………………………………………………………….
Date ………………………………………..
……………………………………………….
Signature