Withdrawal

You can use this model form if you wish to withdraw from the contract.

— To:

De Groene Drogist
Linieweg 46
3831WB, Leusden
Nederland
[email protected]

— I/We () hereby notify You that I/We () withdraw from the Agreement relating to the sale of the following goods / provision of the following service ():

— Ordered on () / Received on (*):

— Name of Consumer(s):

— Address of Consumer(s):

— Signature of Consumer(s) (only if this form is submitted on paper):

— Date: