Declaration of Withdrawal Sample
(Fill out and return only if the contract is intended to be terminated)
Address: Éva Szabó Barna private entrepreneur
Return postal address: Mérey utca 16. 2nd floor 10th door, 6722 Szeged, Hungary
Return email address: evetkeswear@gmail.com
Phone Number 1: +36 20 4124 226
Phone Number 2: +381 61 6162 747
I/We, the undersigned, declare that I/We am/are exercising my/our right of withdrawal/termination of the contract for the sale of the following product (s):
Product Article number Name of Product
1. _________________________ _________________________
2. _________________________ _________________________
3. _________________________ _________________________
4. _________________________ _________________________
5. _________________________ _________________________
Date of contracting: ____________________
Name of consumer (s): ______________________
Address of consumer (s): ______________________
Signature of consumer (s): ____________________ (only on paper declaration)
Done at ________________ __________________