ANNEX 2
Book VI Economic Law Code
MODEL WITHDRAWAL FORM
(Complete and return this form only if you wish to withdraw from the contract)
- To
[here the company, its name, address and e-mail address must be entered]
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- I/We (*) hereby give notice that I/We (*) withdraw from my/our (*) contract of sale of
the following goods (*)/provision of the following service (*) withdraw(*)
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- Ordered on (*)/Received on (*).....................................................................................................................
- Name(s)/Name(s) of consumer(s) ........................................................................................................................
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- Address of consumer(s) .......................................................................................................................................
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- Date ...............................................................................................................
- Signature of consumer(s)
(only if this form is submitted on paper)
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(*) Delete what does not apply.