Sample of the withdrawal form

Withdrawal from the contract form

(Fill in this form and send it only if you with to withdraw from the contract)

Withdrawal from the contract notice

- Recipient: TROELL s.r.o., Doubravská 1615/28, 415 01 Teplice

- I/We (*) wish to inform you that I/We (*) hereby withdraw from the contract for the following goods (*):

- Order date (*)/Date of delivery (*):

- Document number (order/delivery note/invoice (*)):

- First name and surname:

- Customer Address:

- Customer signature (only if you send this form by post):

- Date:

(*) Choose the correct option or add any necessary information