Withdrawal form

Model withdrawal form

(only fill in and return this form if you want to cancel the contract)

• To: Brick by Brick diamond painting ( stating return )

Tjalk23 16

return@dutsj.nl

• I/We* share(s)* hereby informing you that I/We* concerning our agreement

the sale of the following products: [description of product]*

revoked/revoked*

• Ordered on*/received on* [date of order for services or receipt for products]

• [Name of consumer(s)]

• [Address consumer(s)]

• [Signature consumer(s)] (only if this form is submitted on paper)

• [Date]

* Strike out what is not applicable or fill in what is applicable.