Online completion Download document

Notice of withdrawal
(sample)
(complete and return this form only if you wish to withdraw from the contract)

To: HYD Rákkutató és Gyógyszerfejlesztő Korlátolt Felelősségű Társaság, 1119 Budapest, Fehérvári út 79., Hungary, info@preventa.hu

I/We hereby give notice that I/We withdraw from my/our contract of sale of the following goods / for the provision of the following service:

Product(s):
................................................................................
................................................................................
................................................................................

Ordered on / received on:
................................................................................

Name of consumer(s):
................................................................................

Address of consumer(s):
................................................................................

Date:
........................................

Signature of consumer(s) (only if this form is notified on paper):
........................................