withdrawal form
Affair: Withdrawal of the contract
At:................................., at........... ../............/............
For the attention of:
Owner of the following online commerce website: lassique.com
Company Name: MANZANO PROYECTOS E INTERIORISMO SL
NIF: B16983181
Marqués de Nervión 89, 2ºa, 41005 Seville.
Telephone: 601190257
Email: sales@lassique.com
By means of the present, I/we inform you of my/our willingness to WITHDRAW our contract of sale of the following goods or products:
Type of product(s) and description of the same(s) (include, if applicable, the reference number):
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Order number: ................................................................ ................................................................ ........
Date on which the order was placed or signed: ................................................................ ...............
Date of receipt of the order: ............................................ ................................................................ ..
Name and identity document (DNI/NIE/Passport) of the consumer(s) and user(s) (copy attached):
................................................................ ................................................................ ..........................
Address of the consumer(s) and user(s):
................................................................ ................................................................ ................................................................ ...
Telephone of the consumer(s) and user(s):
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Email address of the consumer(s) and user(s):
................................................................ ................................................................ ..........................
Name and address of the recipient of the shipment (only if the address is different from that of the consumer(s) and user(s)) :
................................................................ ................................................................ .............................
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Signature of the consumer(s) and user(s)
(Only if the form is submitted on paper)