Withdrawal form

If you wish to withdraw from the contract, please complete this form and return it to us.

To:
Yakelos
Meer en Duin 313
2163HE Lisse
The Netherlands
E-mail: klantenservice@yakelos.com

I/we () hereby withdraw from the contract concluded by me/us () for the purchase of the following goods ()/the provision of the following service ()

Ordered on ()/received on ()
Name of consumer(s)
Address of consumer(s)
Signature of consumer(s) (only if this form is submitted on paper)

Date

(*) Delete as appropriate.