Model withdrawal form

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

Markbass S.p.A., Via Po 52, 66020 San Giovanni Teatino (CH), Italy · care@markbass.it

I/We hereby give notice that I/We withdraw from my/our contract of sale of the following goods:
________________________________________________________________

Ordered on / received on:
________________________________________________________________

Order number:
________________________________________________________________

Name of consumer(s):
________________________________________________________________

Address of consumer(s):
________________________________________________________________

Email address for the receipt:
________________________________________________________________

Signature of consumer(s) (only if this form is sent on paper):
________________________________________________________________

Date:
________________________________________________________________

Delete as appropriate.