WITHDRAWAL FORM

Complete and return this form only if you wish to withdraw from the contract.

To: MGR Conseils, Les Petits Champs, 12 rue Auber, 86000 Poitiers, France
Email: ranjonmarc@mgrconseils.fr

I hereby notify you that I withdraw from my contract of sale of the following goods:

Items:
Ordered on / received on:
Consumer name:
Consumer address:
PayPal transaction reference:
Date:
Signature (paper forms only):