Model withdrawal form

To: B2Y / Genisis Businesses en services
KvK number 42118561
VAT identification number NL005508454B08
Hubert Duyfhuysstraat 44
3553 VX Utrecht
Nederland
Email: contactus@b2ystore.eu

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

Product(s):
Order number:
Ordered on:
Received on:
Consumer name:
Consumer address:
Consumer email:
Date:

Consumer signature, if this form is sent on paper: