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Form for Withdrawal from the Purchase Contract

Annex No 1
Form for Withdrawal from the Purchase Contract
(fill in and send this form only if you want to withdraw from the contract)
 
For Daša Kozmérová – Bubulákovo, Lužná 2320/6, Šaľa, 927 05, info@bubulakovo.sk, +421 905 383 904
 
I/we hereby inform you (*) that I am/we are withdrawing (*) from the purchase contract concerning the following goods/from the contract on this service provision (*):  ..............
 
Date of order/Date of receipt (*) ..............
 
Customer´s name/ Customers´ names (*) ...............
 
Customer´s address/ Customers´ addresses (*) ..............
 
Customer´s signature / Customers´ signatures (*) (only if this form is sent in print)  ..........................
 
Date ..................
(*) Strike out as appropriate