Model Withdrawal Form. To [here the trader’s name, geographical address and, where available, his fax number and e-mail address are to be inserted by the trader]: — I/We (1) hereby give notice that I/We (1) withdraw from my/our (1) contract of sale of the following goods (1)/for the provision of the following service (1), — Ordered on (1)/received on (1), — Name of consumer(s), — Address of consumer(s), — Signature of consumer(s) (only if this form is notified on paper),
Model Withdrawal Form. (If you want to withdraw from the contract, please fill out this form and send it back.)
Model Withdrawal Form. (Please complete and submit this form only if you wish to cancel) To the attention of ETEP Opérations SNC, a general partnership with capital of 250,000 euros, whose registered office is located at 0-00 Xxxxxx Xxxxx Xxxxxxx - 92300 Levallois-Perret: I/We hereby notify you of my/our intention to exercise my/our right of withdrawal in respect of the following order: - Ordered on: Received on: - Name of customer(s): - Address of customer(s): - Date: Order number: Order amount: Date and signature of customer(s):
Model Withdrawal Form. To Crosscard S.A. (email: xxxxxxx.xx@xxxxxxxxx.xxx; postal address: Crosscard S.A., 00-00, Xxx Xxxxxx Xxxxxxxx, L-2540, Luxembourg) —I hereby give notice that I withdraw from my contract for the provision of the following service: —Name of consumer —Address of consumer —Signature of consumer (only if this form is notified on paper) —Date
Model Withdrawal Form. If you wish to withdraw from this Agreement, please fill in the form below and send it back to us: “To GT Media World, LLC with registered address: 000 Xxxxx Xxxxxxxxx Xxx Xxxxxxxx, XX 00000 XXX. I/we (*) hereby withdraw from the agreement concluded by me/us (*) on the purchase of the following goods (*) / the rendering of the following services (*): Ordered on (*) / received on (*): Name(s) of the consumer(s): Address of the consumer(s): Signatures of the consumer(s) (only in case of notification on paper) Date (*) Delete as applicable.”
Model Withdrawal Form. (If you want to revoke the contract, please fill out this form and return it to VERBI.) To: VERBI Software. Consult. Sozialforschung GmbH, Xxxxxxxxxxxx. 00, 00000 Xxxxxx, E-Mail: xx@xxxxxx.xxx I / We (*) hereby give notice that I / We withdraw from my / our contract of sale of the following goods (*) / the provision of the following service (*): Ordered on (*) / received on (*) Name of consumer(s) Address of the consumer(s) Signature of the consumer(s) (only if this form is notified on paper) Date
Model Withdrawal Form. To (postal address and e-mail address can be found in Appendix 1) —I hereby give notice that I withdraw from my contract for the provision of the following service: —Name of consumer —Address of consumer —Signature of consumer (only if this form is notified on paper) —Date
