Appendix 1: Template – withdrawal form
Dear Customer, you should only complete this form and return it should you want to withdraw from the agreement.
To Storms Evelyn, Parkstraat 28, 9820 Merelbeke, Belgium – stormsevelyn@gmail.com:
I/We (*) hereby inform you that I/we (*) want to withdraw from the agreement concerning the sale of the following goods/delivery of the following service (*):
Ordered on (*)/Received on (*):
Name/Names of consumer(s):
Address of consumer(s):
Signature of consumer(s) [only when this form will be submitted on paper]:
Date:
(*) = strike out what is not applicable.
