Model Cancellation Form

- To Quest General partnership Kiderys and Krawiec, ul. Przylep - Zakładowa 5, 66-015 Zielona Góra, Poland, [email protected]

- I / we [*] hereby give notice that I / we [*] cancel my / our [*] contract of sale of the following goods [*] / for the supply 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 notified on paper)

- Date

[*] Delete as appropriate