Withdrawal form

Please complete and return this form only if you wish to cancel your purchase.

For the attention of Aude Herouard at head office  is located at 3 route du sucre 76450 SASSEVILLE.

I/We (*) hereby notify you (*) of my/our (*) withdrawal from the contract for the sale of the following goods (*)/provision of services (*):

Ordered on (*)/received on (*) : 

Name of consumer(s) : 

Address of consumer(s) : 

Signature of consumer(s) (only in the case of notification of this form on paper) : 

Date : 

(*) Delete as appropriate.

Please return this document with the article(s) concerned to the following address:
Aude Herouard - 5 rue Santeuil 44 000 NANTES