ORDER CANCELLATION FORM

From a distance and off-premises contract statement of withdrawal. (Please complete and return this form only if you wish to withdraw from the contract.)

To:
SA Arvo Pärdi Keskus
Reg. no. 90003870
Address: Kellasalu tee 3, Laulasmaa, 76702 Lääne-Harju vald
ph: (+372) 604 0470
e-mail: info@arvopart.ee


I hereby withdraw from the contract relating to the following goods:


Date of order/date of receipt of goods:

Consumer Name:

Consumer contact details (phone, e-mail, address):


Consumer's bank account number and name of the bank account holder:


Consumer signature:

Date: