Withdrawal form

 

Withdrawal form

(fill out and return this form only if you want to revoke the agreement)

To :Handelsonderneming Roozeboom

Zelhorstweg 12 7739 PN Vinkenbuurt

06-46431334

0523-657262

Administratie@Roozeboom.nu

KvK-nummer: 52229645

Btw-identificatienummer: NL8056.46.309.B.02

I/we (*) share/share (*) you hereby that I/we (*) our agreement on the sale of the following goods/supply of the following recall/withdraw service (*) (*):

 

— Ordered on (DD-MM-YYYY):

— order number:

— received on (DD-MM-YYYY):

— name of consumer (s)

— Address consumer (s):

— IBAN account number:

— signature and data from the consumer (s) (only if this form is submitted on paper) (*) delete if not applicable

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