Sample declaration of withdrawal from a purchase order

 

Addressee: Calendula Pharma Co. Ltd. 8653 Ádánd, Darázsi u. 3.
E-mail: contact@calendulapharma.com, calendulapharma1@gmail.com

I/We, the undersigned, declare that I/we exercise my/our right of withdrawal/cancellation in respect of the contract for the purchase of the following product(s) or the provision of the following service(s):

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Date of conclusion of contract/acceptance:

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Name of the consumer(s):

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Address of the consumer(s):

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The purchase price should be returned to the following bank account (please fill in if you would like to receive a bank transfer):

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Signature of the consumer(s): (only in case of paper declaration)

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Cf.: ................................................................................., 202...... .................................................... on the day of .................. month.