Model withdrawal form

Return this completed form only if you wish to withdraw from the contract.

I/We (*) hereby give notice that I/We (*) withdraw from the contract for the sale of the following goods (*)/for the supply of the following service (*):

Ordered on (*)/received on (*):

Name of consumer(s):

Address of consumer(s):

Signature of consumer(s) (paper form only):

Date:

(*) Delete as appropriate.