Model withdrawal form – complete and send this form only if you wish to withdraw from the contract. Using the form is not obligatory – you can make your statement of withdrawal in any form.
Recipient
ZERIVA sp. z o.o. (Falesia Lima store)
ul. Ogniowa 2/5
02-495 Warszawa, Poland
e-mail: info@falesiastore.com
phone: +48 575 859 907
How to send the form
The form can be sent by e-mail to info@falesiastore.com or by post to the recipient’s address above.
Return address for the goods
Falesia Lima – return, ZERIVA sp. z o.o., ul. Ogniowa 2/5, 02-495 Warszawa, Poland
Model withdrawal form
(complete and return this form only if you wish to withdraw from the contract)
To: ZERIVA sp. z o.o. (Falesia Lima store), ul. Ogniowa 2/5, 02-495 Warszawa, Poland, e-mail: info@falesiastore.com
I/We (*) hereby give notice that I/We (*) withdraw from my/our (*) contract of sale of the following goods: …………………………………………………………….
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: ……………………………………..
(*) Delete as appropriate.
Additional information (optional – makes the return easier)
- Order number: ……………………………………..
- Phone or e-mail for contact: ……………………………………..
- Bank account number for the refund (fill in only if you want the refund by bank transfer instead of the means of payment used for the purchase): ……………………………………..
Final information
You have 14 days from receiving the goods to withdraw from the contract. Send the goods to the return address above no later than 14 days from the day you send us your statement; you bear the direct cost of returning the goods. We refund the money using the same means of payment that was used for the purchase, within 5 business days of receiving the parcel or the proof of its dispatch – and, as required by law, no later than 14 days from receiving the statement of withdrawal (until we receive the parcel or the proof of its dispatch, we may withhold the refund).