Withdrawal Form

Appendix I: Model form for right of withdrawal

 

Model form for right of withdrawal

 

(this form should only be completed and returned if you want to withdraw from the contract)

 

-           To:       [trader’s name]

[trader’s geographic address]

[trader’s fax number, if available]

[trader’s e-mail address or electronic address]

 

-           I/we* herewith inform you that, in respect of our contract regarding

The sale of the following products: [description of the product}*

The delivery of the following digital content: [description of the digital content]*

The supply of the following service: [description of the service]*

 

I/we* exercise our right of withdrawal.

 

 

-           Ordered on*/received on* [date of ordering services or receiving goods]

-           [Consumer(s)’ name]

-           [Consumer(s)’ address]

-           [Consumer(s)’ signature] (only if this form is submitted on paper)

-           [Date]

 

 

*Delete or provide supplementary information, as applicable.