Withdrawal form

Model withdrawal form

To: FCS GROUP ENGINEERING — SRL, Avenue Kersbeek 308, 1180 Uccle, Belgique.

I/We hereby give notice that I/We withdraw from my/our contract of sale of the following goods: [goods and quantity]. Ordered on / received on: [dates]. Order reference: [reference, if available]. Name of consumer(s): [name]. Address of consumer(s): [address]. Date: [date]. Signature of consumer(s), only if this form is notified on paper. Delete as appropriate.

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