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Model withdrawal form

Annex to the Terms of Sale ThemePhil

(Complete and return this form only if you wish to withdraw from the contract.)

To:

ThemePhil
Rector Simonsstraat 10
6174 RK Sweikhuizen, the Netherlands
E-mail: info@themephil.com

I/We* hereby give notice that I/we* withdraw from my/our* contract of sale of the following goods*:

Description of the goods (Item): ___________________________________

_______________________________________________________________________

Order number (if known): ____________________________________________

Ordered on*: ________________________________________________________

Received on*: _______________________________________________________

Consumer details:

Name of consumer(s): ________________________________________________

Address of consumer(s): _____________________________________________

_______________________________________________________________________

E-mail address (for processing): ____________________________________

IBAN for the refund (if desired): ___________________________________

Signature of consumer(s) (only if this form is notified on paper):

_______________________________________________________________________

Date: _______________________________________________________________

* Delete as appropriate.

Note: you may withdraw from the contract within 14 days of receipt of the Item without giving any reason. You may send this form to ThemePhil by e-mail or by post; the use of this form is not obligatory — any other unequivocal statement also suffices. Then return the Item, properly packaged, within 14 days of your notification. See Article 7 of the Terms of Sale ThemePhil for the full conditions, including the careful handling of philatelic material during the cooling-off period. This form is a translation of the Dutch original; in the event of any difference in interpretation, the Dutch text shall prevail.