Cancellation Form

To Arkadiusz Pelc Zlota Wysepka

Ul. Góralska 19/2

80-292 Gdańsk

Poland

shop@arpelc.com

I/ We hereby give notice that I/ we cancel my/our contract of sale of the following goods: …………………………………………………………………. ……………………………………………………………………………………… ………………………………………………………………………………………

Price paid for the item and shipping cost : ……………………………………

Ordered on: …………………………………………………………….

Received on: …………………………………………………………….

Name of Consumer:………………………………………………………………........................

Address of Consumer:……………………………………………………………........................

E-mail: …………………………………………………………………………….........................

Signature Date

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Widerrufsformular

An Arkadiusz Pelc Zlota Wysepka

Ul. Góralska 19/2

80-292 Gdańsk

Poland

shop@arpelc.com

Hiermit widerrufe(n) ich/wir den von mir/uns abgeschlossenen Vertrag über den Kauf der folgenden Waren/die Erbringung der folgenden Dienstleistung:

…………………………………………………………………....................................................... ………………………………………………………………………………………....................... ……………………………………………………………………………………….......................

Bestellt Am:……………………………………………………………………………..................

Erhalten Am:.................................................................................................................................... Name des/der Verbraucher(s):…………………………………………………………………… Anschrift des/der Verbraucher(s):………………………………………………………………..

e-mail:………………………………………………………………………………………………

Unterschrift Datum

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