Withdraw from the contract

Withdrawal from a distance contract

in the sense of Act no. 250/2017 Z. z. on Consumer Protection, as amended, in the sale of goods or the provision of services under a distance or off-premises contract and the amendment of certain laws

buyer:

Name and surname*:

Street and number*:

Village, Town *:

Postcode, State *:

Phone:

E-mail:

Seller:

Business name*:

ID *:

Street and number*:

City *:

Post Country *:

Phone:

E-mail:

I hereby notify you that I am withdrawing from the Purchase Agreement.

The subject of the contract was purchased through the website *: ... ........................................ ....

I have received a confirmed order number *: ... ...................... of the day: ................ .............................

My goods arrived on (receipt date) *: ............................ invoice number: ... ....... .......................

I therefore ask for a refund:

- full invoice value (all invoiced goods are subject to cancellation) °

- partial invoice value (only part of the goods is subject to cancellation) °

/ name of the returned subject of the contract, and the number of pieces (only if you return only part of the subject of the contract):

... ................................................. .................................................. .................................................. ...............

Requested return value: ... ............................................ .................................................. ..................

Required amount to return *:

(a) by transferring to account number: (please specify in IBAN form, SWIFT for non-SEPA payments) °:

... ................................................. .................................................. ...........

b) by postal order at my address (if you paid the goods for pickup - for a cash on delivery in Slovakia)

Shipment Summary: Withdrawal °, Copy of Tax Document -Facture °, Goods °

If the goods are not part of the consignment, I note the fact that the seller is not obliged to return the money within 14 days from the date of delivery of the withdrawal, until the goods are delivered to him or do not prove the sending of the goods.

At the latest within 14 days of the date of resignation, I am obligated / obliged to send the goods to the seller.

* required

° Delete as inappropriate

                                                                                                                     -------------------------------------------------- -----------------

                                                                                   signature of buyer

In ... ................................ on ... .............. .............................

Seller's Notes:

Withdrawal of the day: _______________ Service of cancellation of the day: _______________

Delivery of the goods on: _______________

Date of refund: _______________ Internal resignation number: _______________

Remarked: _______________ Checked: _______________