Model notice
Withdrawal form
Complete and return this form only if you wish to withdraw from an eligible contract. You may instead send any other unambiguous withdrawal statement. Keep a copy and proof of when it was sent.
Send to
I/We give notice that I/We withdraw from the contract of sale for the following goods:
Goods
Order number
Ordered on
Received on
Consumer name
Consumer address
Date
Consumer signature (only if this form is sent on paper)