WITHDRAWAL FORM

To the attention of HV JOYEROS, SL
VAT number: ES B88495247
Address: Calle Núñez de Balboa, 32, 28001, Madrid
Email: havanajoyeros@havanajoyeros.es

I hereby inform you that I am withdrawing from my sales contract with the following details:

Name and surname of the consumer: ______________________________
Consumer address: ______________________________
Contact phone number and/or email: ______________________________
Order number: ______________________________
Product(s) to return: ______________________________
Order receipt date: ______________________________
Consumer signature (only if submitted on paper): __________
- Date: ___ / ___ / ___