Send & withdrawal form

Annex I: Model withdrawal form     
Model withdrawal form   ( Just fill in this form and return when you want to withdraw from the contract )  

To: [ Name entrepreneur ] [ Geographic address operator] [ Fax entrepreneur, if available ] [Email address or electronic address of operator]  

- I / We * share / share * hereby give notice that I / our * contract on the sale of the following products: [ designation product] * the supply of the following digital content [ display digital content ] * the provision of the following service: [ service designation ] * withdraw from my / *  

- Ordered on * / received on * [date order with services or goods receipt at ]   - [Name of consumer (s) ]   - [ Address of consumer (s )]  

- [Signature of consumer (s )] (only if this form is notified on paper)     * Delete if not applicable or fill in as appropriate .