Withdrawal Form
If you wish to withdraw from the sales contract, please fill out this form and submit it.
Company Information
To: Colenis, Terbekehofdreef 71B, 2610 Wilrijk – E-mail: info@colenis.com
Legal Declaration
I/We hereby give notice that I/We withdraw from my/our contract of sale of the following goods:
Name
*
First name
Last name
Email
*
Order Number (e.g., #1045)
*
Description of item(s) / products
*
Ordered on
-
Month
-
Day
Year
Received on
-
Month
-
Day
Year
Submit Withdrawal Now
Should be Empty: