Fill in and send this form only if you wish to withdraw from the contract. You can copy it into an e-mail to [email protected], or print it and post it to the address below.
To:
Anežka Buriánková
Ivana Olbrachta 668, 513 01 Semily
Company ID (IČO): 08490414
E-mail: [email protected]
I hereby give notice that I withdraw from the contract for the purchase of the following goods:
- Order number: ____________________
- Goods: ____________________
- Ordered on / received on: ____________________
- Full name: ____________________
- Address: ____________________
- E-mail / phone: ____________________
- Bank account for the refund: ____________________
Date: ____________________
Signature (only if sending the form on paper): ____________________