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WITHDRAWAL FORM

(Please complete and return this form only if you wish to withdraw from the sales contract and send it by mail, email or fax)

For the attention of CALL INTERNATIONAL located at Drève Richelle 161/16 C at B-1410 Waterloo.
www.callinter.com, tel: +32 2 353 13 00, fax: +32 2 353 08 09, email: waterloo@callinter.com

I / We (*) hereby notify you of my / our (*) cancellation of the contract for the sale of the goods (*) / the service provided (*) below:

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Ordered on (*) / received on (*)

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Name of the consumer (s) (**)

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Address of the consumer (s) (**)

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Date ............................................................................................................... ............ ................

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

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(*)Delete as appropriate
(**) Mention the names and contact details that were used to complete the distance contract
(***) The legal signatory