Notice of withdrawal from the contract

To: Pelješko vino s.r.o., Dominikánské náměstí 256/3, 412 01 Litoměřice, Czech Republic, e-mail: peljesko.vino@gmail.com
I/We (*) hereby give notice that I/We (*) withdraw from my/our (*) contract of sale of the following goods: …
Order number (optional, makes processing easier): …
Ordered on (*) / received on (*): …
Name of consumer(s): …
Address of consumer(s): …
Signature of consumer(s) (only if this form is notified on paper): …
Date: …

(*) Delete as appropriate or complete the details.