(Complete and return this form only if you wish to withdraw from the contract.)
To:
NXTGN BV
Groothertogstraat 55, 1040 Etterbeek, Belgium
info@isthisreal.be
I/We hereby give notice that I/We withdraw from my/our contract of sale of the following goods:
Description of goods:
Ordered on:
Received on:
Order number:
Name of consumer(s):
Address of consumer(s):
Date:
Signature (paper only):
IS THIS REAL? — NXTGN BV — Groothertogstraat 55, 1040 Etterbeek, Belgium — info@isthisreal.be
You are not required to use this form. Any unambiguous written or verbal statement declaring your intent to withdraw is valid.