You do not have to use this form. An email to info@viraine.com is enough.
Model withdrawal form
(Complete and return this form only if you wish to withdraw from the contract.)
To: Virenord (Viraine), Karlavägen 53, 115 26 Stockholm, Sweden. Email: info@viraine.com
I/We (*) hereby give notice that I/We (*) withdraw from my/our (*) contract of sale of the following goods (*)/for the provision of the following service (*):
_______________________________________________
Ordered on (*)/received on (*): _______________________
Name of consumer(s): ______________________________
Address of consumer(s): ____________________________
Signature of consumer(s) (only if this form is notified on paper): ______________________
Date: ___________________________________________
(*) Delete as appropriate.
Conditions: terms of purchase.