Model Withdrawal Form
(complete and return this form only if you wish to withdraw from the contract)
Polish Consumers have a statutory 14-day right to withdraw from a distance contract without giving a reason. This standard withdrawal form (Annex 2 to the Polish Consumer Rights Act) may be used to exercise that right; using the form is not mandatory — any unequivocal statement of withdrawal sent to the Administrator is sufficient.
Addressee:
Konrad Żelazny Glanów 106B, 32-353 Trzyciąż NIP: 6762506379 Email: contact@ambermap.com
Body of the statement:
I/We (*) hereby give notice that I/we (*) withdraw from my/our (*) contract for the supply of the following service: AmberMap Premium subscription.
Date of contract conclusion: _______________________
Name of consumer(s): _______________________
Address of consumer(s): _______________________
Email of consumer(s): _______________________
Signature of consumer(s) (only if this form is sent on paper): _______________________
Date: _______________________
(*) delete as appropriate.
Send the completed form by email to contact@ambermap.com or by post to the address above. Withdrawal received within 14 days of contract conclusion is processed in accordance with our Refund Policy.