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Withdrawal from the contract

Your details

Name*

Last name*

ID

Street, Number*

City*

zip code*

Telefon*

E-mail*

Bank account for refund

Bank account number*

Bank name*

Method of returning goods to the e-shop

Please send the goods to the address:
Adolf Nytra
K Nemocnici 2122/61
Nový Jičín
74101

I hereby notify you that I withdraw from the contract for the purchase of these goods

Order Number*

Order date*

Order delivery date*

Product name*

Note