(Only complete and return this form when you want to cancel the agreement. Download here a PDF file)

To:
Dutch Accent
Berenstraat 41
1016 GG, Amsterdam, NL
info@dutch-accent.nl
+31 20 420 21 20

— I / We (*) hereby inform you that I / We (*) revoke our agreement relating to the sale of the following goods / provision of the following service:

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— Date of purchase (DD-MM-YYYY) :                           — Ordernumber:

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— Delivered on (DD-MM-YYYY):

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— Name/Names consumer(s):

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— Address consumer(s):

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____________________________

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— IBAN Bankaccount number:

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— Signature of the consumer(s) (only if this form be submitted in paper)

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— Date (DD-MM-YYYY):

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(*) Delete what is not applicable.