Model Withdrawal/Cancellation Form

(Please complete and return this form only if you wish to withdraw from the contract.)

To:

Name: Livepoint Kommunikációs, Kereskedelmi és Szolgáltató Korlátolt Felelősségű Társaság

Address: 1095 Budapest, Soroksári út 110–112. Building E, 1st Floor

E-mail: info@livepoint.hu

I/We hereby give notice that I/We withdraw from my/our contract concerning the sale of the following goods or the provision of the following service:

…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

Date of conclusion of the contract / date of receipt of the goods:

………………………………………………………………………………………

Name of consumer(s):

………………………………………………………………………………………

Address of consumer(s):

………………………………………………………………………………………

Signature of consumer(s) (only if this form is submitted on paper):

Date: …………………………………………………………….., 20……………………………………………