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

— To Fastned B.V., Amsterdam,  Amstelplein 44 (1096 BC), [email protected]:

— I/We (*1) hereby give notice that I/We (*1) withdraw from my/our (*1) contract of sale of the following goods (*1)/for the provision of the following service (*1),

— Ordered on (*1)/received on (*1),

— Name of consumer(s),

—Address of consumer(s),

— Signature of consumer(s) (only if this form is notified on paper),

— Date

(*1)  Delete as appropriate.