Withdrawal Form
Addressee
ZŁOTNIK JUBILER WOJCIECH ARASZKIEWICZ al. Wyzwolenia 41/u 1 70-531 Szczecin NIP: 854-154-90-84 email: info@jubileraraszkiewicz.pl
I hereby give notice,
that I withdraw from the contract of sale of the following goods / for the supply of the following service:
Date of contract / receipt of goods:
Consumer's name:
Consumer's address:
Date:
Consumer's signature (only if this form is sent on paper):
Delete as appropriate. The form is not mandatory - any other unambiguous statement of withdrawal will suffice.