Standard Foot Benefit Form
STANDARD WITHDRAWAL FORM
(This form is completed and returned only if the right of withdrawal is exercised)
To:
Ermidio
Ananay v/Andersen
Reberbanen 4A, 1. th.
8800 Viborg
Denmark
Email: info@ermidio.dk
I hereby announce that I wish to exercise the right of withdrawal in connection with my purchase agreement for the following goods/services:
__________________________________________________________________________________
Ordered it: _______________________________
Received on:_______________________________
Consumer's name: __________________________________________________________________________
Consumer's address: ___________________________________________________________________
Consumer's signature: ________________________________________
Date: ______________________
(only if the content of the form is communicated on paper)
Get a link to Ermidio's online returns portal.