WITHDRAWAL FORM

(Complete and send this form only if you wish to withdraw from the contract)

Addressee:
KK-WIRING SIA
Austrumu iela 10
Ogre, Ogres novads, LV-5001
Latvia
E-mail: [email protected]

I hereby give notice that I withdraw from my contract of sale of the following goods: *

Ordered on: *

Received on: *

Name of consumer: *

Address of consumer: *

Date: *