WITHDRAWAL FROM A DISTANCE CONTRACT

I Hereby declare that I withdraw from the distance sales agreement concluded on ................................................ and concerning the purchase of the following goods ............................................................................................. for the price ..................................

The goods were handed over/collected on ...........................................................

In view of the above, I declare that I will return the goods immediately, no later than within fourteen days. I indicate below the details for the return of the price of the goods, which should be done immediately, no later than within fourteen days.

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I am aware that the personal data provided by me will be processed by the Seller for the purposes related to the implementation of the withdrawal from the contract and the fulfilment of requests related thereto and in accordance with the principles set out in the relevant legislation. I know that I have the right to request from the data controller access to my data, their rectification, erasure or restriction of processing, or to object to processing, as well as the right to lodge a complaint to the supervisory authority.

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(name, surname and signature of the Client if the form is sent in hard copy)

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* - delete as appropriate

8.  Claim form template

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(name and surname of the customer)

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(Customer's correspondence address)

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(telephone number for contact)

La-Le Ltd.

ul. W. Glogera 36b

31-222 Krakow

info@la-le.pl