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Form - withdrawal

Addressee:

 

Muzeum medoviny s.r.o. (028 95 048), with registered office K Šafránce 563/3, Praha 9, 190 00, Czech republic

 

Notification of termination of contract

(According to Section §1820 Paragraph 1 Letter f) of the Civil Code and Government Regulation No.

363/2013 Coll.)

 

I / we are hereby notifying the termination from the Buyer’s Contract from [ENTER DATE] Order date / Date of confirming the order of goods: [ENTER DATE]

Purchase order number or invoice number[ENTER ORDER/INVOICE No.] Name and surname of consumer / consumers: [ENTERNAME AND SURNAME] Address of Consumer / Consumers: [ENTER ADDRESS]

Please send me the paid purchase price in accordance with the Business Conditions onto bank account number [ENTER ACCOUNT No.] at [ENTER BANK NAME]

(If no bank account number is stated in the notification, we give the Seller consent to send the stated amount onto the account, from which finances to pay the purchase price were sent.)

 

Signature of Consumer / Consumers:

 

Date: [ENTER DATE]