Model withdrawal form

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

To:

Dermacode by I. Pandourska.

Sofia. Bulgaria.

Phone: +359878440200.

Email: no-reply@dermacodebg.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 (*):

Description of goods / service

Ordered on (*) / received on (*)

Name of consumer(s)

Address of consumer(s)

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

Date