Model withdrawal form

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

To:

Otthonpolc Kereskedelmi Kft.
6000 Kecskemét, Batthyány utca 21.
ugyfelszolgalat@otthonpolc.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:

Ordered on / received on:

Name of consumer(s):

Address of consumer(s):

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

Date:

Source: Annex 2 of Hungarian Government Decree 45/2014 (II. 26.)