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Withdrawal form

Withdrawal form

(Please complete and return this form only if you wish to withdraw from the contract.)

- For the attention of NED SARL 24 rue des Terres Fortes 77600 Chanteloup-en-Brie (France) or by fax: + 33 (0) 1 64 66 77 99 or by email: postmaster@nouvelle-epicerie.fr

- I / We (*) notify you / notify (*) hereby my / our (*) withdrawal from the contract for the sale of the property (*) / for the provision of service (*) below

- Ordered on (*) / received on (*)

- Name of consumer (s)

- Address of the consumer (s)

- Signature of the consumer (s) (only if this form is notified on paper)

- Date

(*) Delete the unnecessary mention.