The Contract Withdrawal Form

The Contract Withdrawal Form
(print its text, fill in the required information and put it in the returned package)

return address:

Vladimira Kelcova
Cerveny Tulipan
U Posty 16
625 00 Brno
Czech Republic

e-mail: obchod(at)cervenytulipan.cz , phone: +420 602 129 222

I hereby withdraw from the Contract of Sale:

invoice number:......................................  or Order number:................................................

(write the name of the product, number of pieces, etc.):

........................................................................

........................................................................

........................................................................

Date of ordering the goods …......................................................................................................

Date of receiving the goods …........................................................................................................

Name, surname and address of the consumer/buyer..............................................................

................................................................................................................................................

IBAN account (only for COD payments): ..............................................................

Date …...............