Retraction Demand Form

(Complete and send us this form only if you wish to withdraw from your order)

Please print, complete and return this form by email to the following email address: web-effect@numericable.fr or by post to the following address: Web Effect, 5 rue Jean Carbon, 52400 Bourbonne les Bains, France. As soon as we receive and process your return request, we will contact you to inform you of the steps to follow to finalize it.

Important - Please do not send us any products to the address above, the team will provide you with the necessary instructions.

I confirm that I wish to withdraw all or part of the following order placed on the store:

Order number*:

_____________________

Order date* :

___ / ___ / _______

Received date* :

___ / ___ / _______

Applicant's first name:

__________________________________________

Applicant's last name:

___________________________________________

Applicant's address:

__________________________________________

__________________________________________

Indicate whether you wish to withdraw from the entire order or only part of it*: 

 __________________________________________

If you wish to withdraw from only one part, please specify which one*: 

____________________________________________________________________________________

____________________________________________________________________________________

Signature of Applicant*: 

Date*:

___ / ___ / _______

Fields with a * are required.

In application of articles L. 221-18 et seq. of the Consumer Code.