(Complete and return this form only if you wish to withdraw from the contract.)
Addressee: Maryna Danylchenko, ul. Jankego 142, 40-613 Katowice, e-mail: store@mediamistrz.eu
I/We hereby give notice of my/our withdrawal from the contract of sale of the following items:
— Order number: ..........................................
— Date of contract / of receipt: ..........................................
— Name of the consumer(s): ..........................................
— Address of the consumer(s): ..........................................
— Bank account number for the refund (optional): ..........................................
— Date: ..........................................
— Signature (only if this form is submitted on paper): ..........................................