MODEL WITHDRAWAL FORM

For the attention of BENOTSHOP :

I/We (*) hereby notify you (*) of my/our (*) withdrawal from the contract for the sale of the goods (*)/provision of the services (*) below:

Ordered on (*)/received on (*) :

Name of consumer(s) :

Address of consumer(s) :

Signature of the consumer(s) (only in the case of notification of this form on paper) :

Date :

(*) Delete as appropriate.

EXCEPTIONS TO THE RIGHT OF WITHDRAWAL

The right of withdrawal does not apply to :

- the supply of services which have been fully performed before the end of the withdrawal period and where performance has begun after the consumer has given his express prior consent and expressly waived his right of withdrawal,

- the supply of goods made to the consumer's specifications or clearly personalised.