Model withdrawal form

Complete and send this form only if you wish to withdraw from the contract. Using this model is optional.

To: MB Supk Kurk, Sodybos g. 26, Šepečių k., Paberžės sen., Vilniaus r., LT-14272, Lithuania; supkkurk@gmail.com
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I/We hereby give notice that I/We withdraw from my/our contract of sale of the following goods:
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Ordered on / received on:
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Name of consumer(s):
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Address of consumer(s):
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Signature of consumer(s), only if submitted on paper:
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Date:
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