Model Withdrawal Form

Last updated: 11 September 2026

Complete this form only if you wish to withdraw from your agreement. Send it by email or post to the recipient below. You can print this page or save it as a PDF using your browser.

To

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

 

Ordered on / received on

 

Consumer name(s)

 

Consumer address

 

Order number (if available)

 

Date

 

Signature (only if submitted on paper)

 

Use of this model form is optional; you may also send another unambiguous statement of withdrawal. Delete whichever wording does not apply.