Annex No. 6 to Art. 47, para. 1, item 8 and Art. 52, paras. 2 and 4 of the Consumer Protection Act
STANDARD WITHDRAWAL FORM
To ...........................
/merchant's name/
................................................................................
/address, UIC/
I hereby notify you that I withdraw from the contract I concluded for the purchase of the following goods/services:
................................................................................................................ /product description/
................................................................................................................ /product description/
................................................................................................................ /product description/
The goods were ordered on ......................
The goods were received on ...................... /state the date of receipt by the consumer/
.................................................................................../Consumer's name/
City/town ...................................................................... /Consumer's address/
................... /Date/ .................................. /Consumer's signature/
The consumer has the right, within 14 days, to withdraw unconditionally from a distance contract or an off-premises contract without incurring any costs, except delivery costs where the consumer has chosen a delivery method other than the least expensive standard delivery method offered by the merchant, as well as the costs of returning the goods.
The 14-day period starts from the date of:
conclusion of the contract – in the case of a service contract;
receipt of the goods by the consumer or a third party other than the carrier.
Within 14 days of stating their intention to withdraw from the contract, the consumer must return the goods to the merchant. Within 14 days from the date on which the merchant was informed of the consumer's decision to withdraw from the contract, the merchant refunds all amounts received from the consumer, including delivery costs.
