Retraction form

Withdrawal Form

For the attention of Ms. Elodie ORTIZ, 124 Boulevard Romain Rolland 13010 Marseille France

E-mail address: elloweencreations@gmail.com

I/We (*) notify you by the present my/our (*) contract withdrawal dealing about the good's sale showed below:

Ordered on (*)/received on (*) :

Consumer's name(s) :

Consumer's address:

Consumers' signature (in case of presentation of the presented paper form):

Date :

(*) Cross the useless mention.