In the event of an end-of-life cycle of the purchased product, the entrepreneur commits to a take-back scheme, offering the consumer options for recycling or disposing of the product responsibly, at no additional cost.
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www.thuiswinkel.org
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Appendix I: Model withdrawal form
Model withdrawal form
(fill out and return this form only if you want to withdraw from the contract)
To: [name of entrepreneur]
[geographical address of entrepreneur]
[fax number of entrepreneur, if available]
[email address or electronic address of entrepreneur]
I/We* hereby inform you that I/we* wish to revoke our contract concerning
the sale of the following products: [description of product]*
the delivery of the following digital content: [description of digital content]*
the performance of the following service: [description of service]*,
revoke/revoke*
Ordered on*/received on* [date of order for services or date of receipt for products] [Name of consumer(s)] [Address of consumer(s)] [Signature of consumer(s)] (only when this form is submitted on paper) [Date]
Cross out what does not apply or fill in what applies.
For the Dutch version, please click
here.
For the German version, please click
here