SAMPLE WITHDRAWAL FORM (EU Directive 2011/83/EU & §1820 Czech Civil Code) Complete and return this form only if you wish to withdraw from the contract. ---------------------------------------------------------------- To: DavidCerny, s.r.o. Zborovská 889/46, Smíchov 150 00 Praha 5 Czech Republic Company ID: 056 84 544 Email: eshop@musoleum.cz ---------------------------------------------------------------- I/We (*) hereby give notice that I/We (*) withdraw from my/our (*) contract of sale of the following goods (*): Order number: ____________________________________________ Description of goods: ____________________________________________ ____________________________________________ Date of order: ____________________________________________ Date of receipt: ____________________________________________ Name of consumer(s): ____________________________________________ Address: ____________________________________________ ____________________________________________ Signature: ____________________________________________ (only if sent on paper) Date: ____________________________________________ (*) Delete as appropriate. ---------------------------------------------------------------- How to send: - Email the completed form to eshop@musoleum.cz, or - Post it to the address above. Then return the goods, in original unused condition, to the same address. Buyer bears the cost of return shipping. Refunds are processed within 14 days of our receipt of the returned goods, using the original payment method. See also Terms & Conditions §5 at musoleum.cz/legal/terms.