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Withdrawal form


Only complete and return this form if you wish to withdraw from the agreement.
Can be submitted digitally via e-mail or by post.

Copypaste this text into your usual word processor on your PC/laptop

At:
Eleoflora, in collaboration with nature
Vlagtwedderstraat 54
9545 TD Bourtange
eleoflora.webshop@gmail.com

I/We* hereby inform you that I/We* have terminated our agreement regarding the sale of the following products: [product designation]* the supply of the following digital content: [digital content designation]* the performance of the next service: [service designation]*, revocation/revocation*

Ordered on*/received on* [date of order for services or receipt for products]

Ordered on*/received on* [date of order for services or receipt for products]

  • [Name of consumer(s)]

  • [Consumer(s) address]

  • [Signature consumer(s)] 
     

* Delete what is not applicable or fill in what is applicable.

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