Contract Withdrawal Form

for the www.pow.sk e-shop


(only complete and send this form if you wish to withdraw from a contract)

– Recipient: Mário Harman – www.pow.sk, Záhradnícka 698/38, 920 41 Leopoldov, Slovak

Republic


– I/We* hereby withdraw from the contract for these goods or contract for the provision of a

service*:


– Date of order/date of receipt*:


– Name and surname of the consumer/consumers*:


– Address of the consumer/consumers*:


If you wish to have your payment refunded to a bank account, please provide the IBAN

number:


– Signature of the consumer/consumers* (only if this form is sent to the Seller in written

form)

.......................................


– Date:


*Cross out the option which does not apply.