Withdrawal Form

for the purpose of returning ordered goods

Seller's Contact Details

VETlímce s.r.o.

Company Registration No.: 11979160

Vltavínová 1334/3, Černice, 326 00 Plzeň

tel.: +420 734 562 220

Pursuant to Section 1829(1) in conjunction with Section 1818 of Act No. 89/2012 Coll., the Civil Code, I hereby exercise my statutory right of withdrawal against the above-named seller, withdraw from the purchase contract concluded by means of an order placed at the internet address www.vetlimce.cz, and declare that I meet the conditions for withdrawal. The details required for this purpose are set out below.

Customer's Contact Details

(details for handling the return)

full name / company name: ____________________________________________________

e-mail: ___________________________________________________________________

telephone: __________________________________________________________________

address: ___________________________________________________________________

Invoice Number

(under which the order was paid)

________________________________

Order Date

(the date on which the goods were ordered)

________________________________

Price of Goods

(as per the order, including currency)

________________________________

Postage Cost

(as per the order, including currency)

________________________________

Returned Goods

(name and quantity of the goods being returned in connection with the withdrawal)

_______________________________________________________________________________

Date of Delivery of Goods

(the date on which the goods were received from the seller or carrier)

__________________________________

Refund Details for Purchase Price and Postage

I wish to receive a refund of the purchase price by bank transfer to the following account:

_______________________________________________________________________________

I wish to receive a refund of the purchase price by another method:

_______________________________________________________________________________

Customer's signature: ___________________

Date of signature: ___________________