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


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

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


  • 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.