Model withdrawal form

This form is for consumers only. Complete and return it only if you want to withdraw from a contract you concluded as a consumer.

To: SMARTEDTECH SL, Carrer Agricultura, 16, 1º, 9ª, 08320 El Masnou, Barcelona, Spain; support@concilera.com.

I/We notify you that I/we withdraw from my/our contract for the following services:

Order/reference: __________
Ordered on: __________
Consumer name(s): __________
Consumer address: __________
Date: __________
Signature only if this form is sent on paper: __________

You may instead send any clear withdrawal statement; this form is not mandatory. Do not include full card details. This form does not create a withdrawal right where none exists by law; your mandatory remedies remain.