Withdrawal form

Place, date
………………………………

Addressee:
MONTEFOREST.COM
MONTEFOREST LIMITED LIABILITY COMPANY
ul. Prusy 12B
05-300 Prusy, Mazowieckie Province, Poland

NIP: 5273042589
KRS: 0001019094

Store monteforest.com

Customer details:

(full name, address, e-mail address, phone number)*

………………………………………………………………………………………………………………………….
………………………………………………………………………………………………………………………….

STATEMENT OF WITHDRAWAL FROM A DISTANCE OR OFF-PREMISES CONTRACT

I hereby declare that, exercising my rights within the 14-day period, I withdraw from the contract concluded on** ………………………………. concerning the purchase/delivery of goods*** (description of goods, order number/invoice number, reason for withdrawal)*

………………………………………………………………………………………………..
…………………………………………………………………………………………………………………………….………….

delivered to me on …………………………………………**

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Date and signature
(if the statement is submitted in writing)

* The customer is obliged to provide the address, the remaining data are optional to fill in
** Please indicate one of the dates: purchase or delivery
*** Delete as appropriate