MODEL WITHDRAWAL FROM THE CONTRACT

(this form should be completed and returned only if you wish to withdraw from the contract)

Addressee: [name of entrepreneur]

Return address: [street, city, zip code]

Email: [if available]

fax: [if available]

- I / We (*) hereby inform / inform (*) about my / our withdrawal from the contract of sale of the following items (*) contract of delivery of the following items (*) contract for a specific work involving the performance of the following items (*) / for the provision of the following service (*)