MODEL WITHDRAWAL FORM
(Please complete and return this form only if you wish to withdraw from the contract)
Recipient:
TRE-MAIK LIMITED LIABILITY COMPANY
Świętokrzyska 30/63
00-116 Warsaw, Poland
Phone: +48 796 300 358
E-mail: kontakt@wiertla-diamentowe.pl
I, ......................................................................................,
hereby give notice that I withdraw from the contract of sale of the following goods:
- Order date: ................................................................................
- Order or proforma invoice number: ...................................................
- Product name: ............................................................................
- Quantity: ................................................................................
Date of receipt of the goods covered by the sales contract:
............................................................................................
Consumer's full name:
............................................................................................
Consumer's address:
............................................................................................
Bank account number for the refund:
............................................................................................
Consumer's signature (only if this form is submitted on paper):
............................................................................................
Date:
............................................................................................