Model Withdrawn Form

MODEL WITHDRAWAL FORM

(complete and return this form only if you wish to withdraw from the contract)

— To “IPHIS”, Agion Panton 77 str., Kallithea 17671, Attica, Greece (info@iphisthelabel.com):

— I hereby give notice that I withdraw from my contract of sale of the following goods:

— Ordered on …… and received on ……..

— Name of consumer,

— Address of consumer,

— Signature of consumer (only if this form is notified on paper),

— Date: