This form should be completed and returned only if you wish to withdraw from the contract.
– Addressee [here the entrepreneur should enter the entrepreneur’s name, full postal address and, if available, fax number and e-mail address]
– I / We (*) hereby inform / inform (*) about my / our withdrawal from contract for the sale of the following items (*) contract for the supply of the following items (*) contract for specific work consisting in the performance of the following items (*) / for the provision of the following service (*)
– Date of conclusion of the contract (*) / receipt (*)
– Name and surname of the consumer (s)
– Address of the consumer (s)
– Signature of the consumer (s) [only if the form is sent in paper version]
(*) Delete as appropriate