MODEL WITHDRAWAL FORM

(Complete and return this form only if you wish to withdraw from the purchase contract.)

To:

ARCARRA s.r.o.
Legerova 1820/39
120 00 Prague 2
Czech Republic
Company ID No. (IČO): 23480271
E-mail: info@arcarra.com

I hereby give notice that I withdraw from the purchase contract for the following goods:

Name of goods and order number:

………………………………………………………………………………..

Date of order:

………………………………………………………………………………..

Date of receipt of goods:

………………………………………………………………………………..

Name, surname, address:

………………………………………………………………………………..

………………………………………………………………………………..

………………………………………………………………………………..

E-mail:

………………………………………………………………………………..

Telephone:

………………………………………………………………………………..

I request a refund of the purchase price by bank transfer to account No. (incl. IBAN/BIC where applicable):

………………………………………………………………………………..

Date and signature

In ……………………………………………….. on ………………………

………………………………………………………………………………..

Signature of the consumer (only if this form is sent on paper)