Withdrawal form

This form must be completed and returned only if the Customer wishes to withdraw from the order placed on https://ausenspratique.com/ except for exclusions or limitations to the exercise of the right of withdrawal according to the applicable General Terms and Conditions of Sale.

To the attention of "Seller's Street Address and Number" "Seller's Postal Code" "Seller's City"

Order of the " ......"

Order number: .............................................. .............

Customer Name: .............................................. .............................

Customer Address: .............................................. .........................

Customer Signature (only if this form is submitted on paper):