Dear Customer, you only need to complete and return this form if you wish to withdraw from the agreement.
To Casa Mimi VOF, Vaartstraat 92 2235 Hulshout, hello@casamimi.be:
I/We (*) hereby inform you that I/We (*) revoke (*) our agreement regarding the sale of the following goods/supply of the following service (*):
Ordered on (*)/Received on (*):
Name(s) of consumer(s):
Address consumer(s):
Signature of consumer(s) [only when this form is submitted on paper]:
Date :
(*) Delete what is not applicable.