Place, date
Consumer name:
Address:
Name and address of the trader:
Statement
About the withdrawal from a distance contract
I declare that pursuant to Art. 7 sec. 1 of the Act of 2 March 2000 on the protection of certain consumer rights and on liability for damage caused by a dangerous product (Journal of Laws No. 22, item 271, as amended) [1]
I am leaving the contract ............................................... ...................... no. ..............................
Concluded on ......................................................in........................................... .......................
Please return the amount ..................... (say: ...................... .................................................. )
via PayPal to: .............................................. ................................................
I'm returning (what products) ................................................. unchanged.
Consumer signature
[1] Article 7 1. A consumer who has entered into a distance contract may withdraw from it without giving a reason by submitting a written statement in writing within ten days, 10 sec. 1.
2. It is not permissible to stipulate that the consumer is free to withdraw from the contract for payment of the indicated amount (allowance).
3. If the contract is terminated, the contract shall be deemed not to have been delivered and the consumer shall be released from all obligations. What the parties have witnessed is reimbursed unchanged, unless the change was necessary within the limits of ordinary management. If the consumer has made any prepayments, they will be subject to statutory interest from the date of prepayment.
Article 10 1. The ten-day period during which the consumer may withdraw from the contract shall be calculated from the date of issue of the goods and when the contract relates to the provision of the service - from the date of its conclusion.