Withdrawal form

Please complete and return this form only if you wish to cancel/revoke the agreement.

To Evelien Lanotte, Hoogstraat 20, 9250 Waasmunster, papegaaishop@gmail.com :

I hereby inform you that I revoke our agreement regarding the sale of the following goods:

  • Ordered on: [date]

  • Received on: [date]

  • Consumer name:

  • Consumer address:

  • Consumer signature (only for paper form):

  • Date: