Withdrawal form

SAMPLE FORM FOR WITHDRAWAL FROM A DISTANCE CONTRACT AND A CONTRACT CONCLUDED OUTSIDE THE MERCHANT'S PREMISES

www.kidsloveblocks.sk

(Fill in and send this form only if you wish to withdraw from a distance contract or a contract concluded outside the trader's premises.)

– To: Mária Lazarová, Žitavská 175/17, 95197, Žitavany, Slovak Republic

– I/we hereby notify* that I/we withdraw* from the contract for the delivery or provision of this product: ..............

– Order date/date of receipt* ..............

– Name and surname of the consumer/consumers* ..............

– Address of the consumer/consumers* ..............

– Signature of the consumer/consumers* (if this form is submitted in paper form) form) ..............

– Date ..............

* Strike out what does not apply