Right of Withdrawal Form

Sample Customer withdrawal form

Withdrawal form

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

 

For the attention of Quantic Dream, 30 rue Raoul Wallenberg, 75019 Paris - France

I hereby notify you of my withdrawal from the agreement for the Product(s) below:

 

____________________________________________________________

 

Received on : _______________________________

     

My name and address:

_____________________________________________

_____________________________________________

_____________________________________________

 

Signature :

 Date :

 

(*) Delete as appropriate.