Model Withdrawal Form

Instructions

To exercise your right of withdrawal, please complete this form and send it to the seller within 14 days of receiving the goods.

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Withdrawal Form

To:
Radosław Michalski
ul. Synów Pułku 34
09-410 Płock
Poland
E-mail: zeit@werkkonzept.com

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Consumer Statement

I/We hereby give notice that I/We withdraw from the contract of sale of the following goods:

Consumer Information

Full Name: _______________________________________________

Address: _______________________________________________

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Phone Number: _______________________________________________

Email Address: _______________________________________________

Order Information

Order Number: _______________________________________________

Date of Receipt of Goods: _______________________________________________

Description of Goods from which I/We Withdraw:

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Signature

Date: _______________________________________________

Signature: _______________________________________________

(if submitted electronically, signature is not required)

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Important Information

• This form must be sent within 14 days of receiving the goods.
• The goods must be returned promptly, but no later than 14 days from the date of sending this withdrawal notice.
• You bear the direct cost of returning the goods to the seller.
• Your refund will be processed within 14 days of the seller receiving the returned goods.

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Model form in accordance with Directive 2011/83/EU