Returns

Statement

Drawn on:
20.05.2012

Name of advertiser:

Shop name:
Internet shop
ZOLLINE

Address advertiser:

Company Address:
CONCEPT JEWELRY
ul. Łozy 9E10, 80-516 Gdańsk

Telephone:

Declaration of avoidance of a distance contract online store ZOLLINE

I declare that, under Article. Paragraph 7. 1 of the Act of 2 March 2000 on the protection of consumer rights and liability for damage caused by dangerous products withdraws from the contract of sale is found confirmation of the order "On line":

no:

concluded on:

in:

Please return the amount in a manner which made the payment of the price / per

bank account:

no:

Printed and signed form must be sent to the company's mailing address:

Concept Jewelery, ul.Nobla 26, 80-172 Gdańsk, Polska

Date: . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Signature: . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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