Model withdrawal form
(fill out and return this form only when you want to withdraw from the agreement) to:
48122TL Breda (The Netherlands)
I/we * part/parts * you also, that I/we * our agreement on the sale of the following products: [product name] * the supply of the following digital content: [digital content indication] * the provision of the following service: [service name] * revoke, revoke/* Ordered/received on * on * [date order with services or receipt at products] [name (s)] [address of consumer (s)] [signature of consumer (s)] (only when this form is submitted on paper)
* delete whichever does not apply or complete as appropriate.