Model withdrawal form

Complete and return this form only if you wish to withdraw from the contract and prefer not to use the online form. You may also send any other clear statement to [email protected].

To: Miguel Rúbene Marques Menezes (Feirix), Rua Diogo Cão, Lote 30, Urb. Monte da Bemposta, 8500-430 Portimão, Portugal — [email protected]

I hereby give notice that I withdraw from my contract of sale of the following goods: ___

Ordered on ___ / received on ___

Name of consumer: ___

Address of consumer: ___

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

Date: ___

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