Withdrawal Form

MODEL WITHDRAWAL FORM

 

(Complete and return this form only if you wish to cancel your order. Please send it by email to support@tiiczw.com. You can also withdraw online via the "Withdraw from contract here" button on our website.)

 

To:

Nose Trading B.V.

Calandstraat 88 F

3125 BB Schiedam

Zuid-Holland, the Netherlands

Email: support@tiiczw.com

 

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

 

Product(s): ______________________________________

 

Order number: ____________________________________

 

Ordered on* / Received on*: ______________________

 

Name of consumer(s): _____________________________

 

Address of consumer(s): __________________________

 

__________________________________________________

 

Email address: ___________________________________

 

IBAN (only if refund cannot be made via the original payment method): ____________________

 

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

 

Date: ____________________

 

* Delete as appropriate.