Withdrawal form

Updated October 10, 2026

You may use this model form to withdraw from a distance purchase. Use it only if you wish to withdraw. You may also send any other clear statement; this form is optional and a reason is not required.

Copy, complete and send

Send the completed form by email to info@glasatelierclaire.nl or by post to Glasatelier Claire, Rijksweg 23, 6085 AA Horn, The Netherlands. You can print or save this page using your browser.

To: Glasatelier Claire, Rijksweg 23, 6085 AA Horn, The Netherlands; info@glasatelierclaire.nl

I/We (*) hereby give notice that I/We (*) withdraw from my/our (*) contract of sale of the following goods (*) / for the provision of the following service (*):

................................................................

Ordered on (*) / received on (*): ................................

Name of consumer(s): ................................

Address of consumer(s): ................................

Signature of consumer(s) (only if this form is notified on paper): ................................

Date: ................................

(*) Delete as appropriate.

To help me find your order, you may add your order number and email address. These additions are not mandatory parts of the model form.

After your notice

Keep a copy and your sending evidence. For the deadline, return address, return postage, refund and exceptions, read my returns and withdrawal policy. A timely withdrawal does not depend on my permission.