Create your own personalized polosLees het verhaal
form (Fill in and return this form only if you wish to withdraw from the contract)
Chemin de l'etoquois 511 i
7742 Herinnes, Belgium
I/We (*)____________________ share(s) (*) you hereby give notice that I/we (*) revoke/revoke our agreement concerning the sale of the following goods/provision of the following service (*)____________________ (*)
Ordered on (*)____________________ /Received on (*)____________________
Name/Names consumer(s) ____________________
Address consumer(s) ____________________
Signature of consumer(s) (only when this form is submitted on paper)
(*) Strike out as appropriate
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