Return Form


Appendix I: Standard form for withdrawals Standard form for withdrawals

(Please, only fill in and return this form if you would like to use your right of withdrawal)


  • I/we* am/are* informing you that I/we* would like to withdraw our agreement concerning the sale of the following products: [ product designation ]*
  • Ordered/received* on [ date order of services or reception of products ]


  • [ Name consumer(s) ]


  • [ Address consumer(s) ]


  • [ Signature consumer(s) ] (only when this form is submitted in paper form)


* Strike out whichever is not applicable.