Withdrawal form

MODEL WITHDRAWAL FORM FOR A DISTANCE CONTRACT
AND AN OFF-PREMISES CONTRACT OF THE TRADER

 

(Complete and send this form only if you wish to withdraw from a distance contract or from an off-premises contract of the trader.)

 

- To: CHEMOSVIT FOLIE, s.r.o., registered office: Štúrova 101, 059 21 Svit, Slovak Republic, e-mail:

I/We* hereby notify you that I/we* withdraw from the contract for the supply or provision of the following product: ........................................

- Date of order/date of receipt* ........................................

- Name and surname of the consumer/consumers* ........................................

- Address of the consumer/consumers* ........................................

- Signature of the consumer/consumers* (only if this form is submitted in paper form) ........................................

- Date ........................................

* Delete as appropriate.