Model withdrawal form

Only complete and return this form if you wish to withdraw from the agreement. Use is not mandatory: any other clear statement also suffices.

To:
SJELF. / D Ent Consulting
Prickwaert 34
3363 BC Sliedrecht, The Netherlands
hello@sjelfmusic.nl
06 17663418

I/We (*) hereby give notice that I/we (*) withdraw from my/our (*) contract of sale of the following goods/provision of the following service (*):

Product(s) / service:
................................................................................................
................................................................................................

Ordered on (*): ................................ Received on (*): ................................

Order number (if known): ................................................................

Name/Names of consumer(s): ................................................................

Address of consumer(s): .........................................................................
................................................................................................

Signature of consumer(s), only if this form is submitted on paper:

................................................................................................

Date: ................................

(*) Delete as appropriate.