Place, date
Customer’s name and surname:
Customer’s address:
Addressee: Homa Holistics Sp.z.o.o.
ul. Wysoka 151
34-240 Jordanów
e-mail:
info@homatherapypoland.org
phone: 502347898
FORM OF WITHDRAWING FROM A LEGAL AGREEMENT
(this form should be filled in and returned only if you wish to withdraw from the contract)
I, the undersigned, hereby inform about my withdrawal from the sales contract of the following:
The date of conclusion of the contract:
Date of receipt:
Signature of the Customer
(only if the form is sent in paper version)