Withdrawal Form

Model withdrawal form

(only complete and return this form if you wish to cancel the contract/purchase)

Send to: Yunikon

Postbus 5545
4801 DZ Breda

The Netherlands

info@nullyunikon.org

I / We * share / share * hereby inform you that I / we * regarding our agreement the purchase of the following products:

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Revocation / revocations*

Ordered on / received on [date of order and receipt of products]:

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Name consumer(s):

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Address consumer(s):

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Signature consumer(s) (only when this form is submitted on paper):

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*) = Delete what does not apply or fill in what applies.