Model withdrawal form

Model withdrawal form

(this form fill and only return if you wish to withdraw from the contract)
Aan
Mellody Casuals V.O.F.
settlement- & visiting address:
Rijswijkstraat 185 Unit 153
1062 EV Amsterdam
Nederland
T: +31 – (0)20 – 615 48 53
M: +31 – (0)6 – 54 78 31 27
E-mail Address: Info@Mellodycasuals.nl
Kvk- number: Amsterdam 33249760
Btw- identification number: NL.815060142 B01

I / We (*) part / parts (*) hereby give notice that I / We (*) withdraw from my / our contract for the sale of the following goods / provision of the following services (*) (*):

Ordered on (DD-MM-YYYY) :

Received on (DD-MM-YYYY):

Order number :

Name / s consumers(en)

Address of consumer (en) :

IBAN bank account:

On Hand drawing from consument(en) (only if this form is notified in writing)

Date(DD-MM-YYYY):