Withdrawal Form

Withdrawal Form

Complete and return this form only if you wish to withdraw from your purchase.

To:

Mateo Kunert
Trading as: Relyvanta
Weststraße 1, 06773 Gräfenhainichen
Germany

Email: returns@relyvanta.com

I/We hereby withdraw from the contract for the purchase of the following goods:

________________________________________

Order number:

________________________________________

Ordered on:

________________________________________

Received on:

________________________________________

Name of consumer(s):

________________________________________

Address of consumer(s):

________________________________________

Email address used for the order:

________________________________________

Date:

________________________________________

Signature, only if submitted on paper:

________________________________________