(only fill in this form and return it if you wish to withdraw from the contract)

To:Paspartoet
Calle Piedra de Luna 12, 03710 Rojales, España
info@paspartoet.nl

I hereby give notice that I withdraw from our contract for
the sale of the following products:

ordered by [datum datumbesteld placeholder "date of order"]

Order number

received on [datum datumontvangstproducten placeholder "date of receipt of products"]

Name
Address
E-mail [e-mail emailconsument placeholder "e-mail address customer"]
IBAN account number

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