Directive 2011/83/EU · Annex I(B)
Model withdrawal form
Complete and return this form only if you wish to withdraw from the contract. You are not obliged to use it — any clear statement that you withdraw is enough, and you do not have to give a reason. The conditions, including the consent given at checkout to immediate delivery, are explained in the right of withdrawal notice.
How to send it
- By email — open a pre-filled email, or write your own message to hello@assaygrade.com. Email is enough; no signature is needed.
- By post — print this page, complete and sign it, and send it to the address below.
- Receipt is acknowledged by email without delay. The withdrawal is in time if it is sent before the 14-day period ends.
Model withdrawal form
To
Bit State, MB
small partnership (mažoji bendrija), registration number 307056143
Šeduvos g. 29-14, Padubysio k., LT-83250 Pakruojo r.
Republic of Lithuania
Email: hello@assaygrade.com
I/We (*) hereby give notice that I/We (*) withdraw from my/our (*) contract of sale of the following goods (*)/for the provision of the following service (*):
Ordered on / received on:
Order or receipt number (if known):
Name of consumer(s):
Address of consumer(s):
Email address used at purchase:
Date:
Signature of consumer(s) (only if this form is notified on paper):
(*) Delete as appropriate.
Wording follows Annex I(B) to Directive 2011/83/EU. Some member states publish a prescribed national-language version of this form; where that applies to you, that version may be used instead.