Withdrawal from Contract Form

Customer

Full name *

Please enter your full name.

Address *

Please enter your address.

E-mail *

Please enter a valid e-mail address.

Subject of withdrawal

Order number or other identifier *

Please enter the order number.

Scope of withdrawal *

Please select the scope of withdrawal.

Refund method

Same payment method as used for the purchase To a bank account

Bank account number *

Please enter the bank account number.

I hereby give notice that I withdraw from the contract for the goods / services listed above, concluded through your online store.

Please review the details you entered and confirm your withdrawal from the contract by clicking the button below. After confirmation, we will send you an e-mail confirmation.

Withdrawal has been sent

We have sent a confirmation to the e-mail address you provided.
It contains the date and time your withdrawal was received.
We will contact you regarding the next steps.