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Cancellation form

(This document or letter should only be completed and sent if you wish to withdraw from the contract for an online purchase).

Subject: Cancellation of the contract

On________ at______ from_________ from _______

To the attention of:


CIF/NIF: B12961421

Address: Calle Isabel La Catolica 8 46004 Valencia

Telf. 0034 964 237 976

E-mail: jurí

Owner of the following e-commerce website:

I/We hereby inform you of my/our willingness to DISCONTINUE our contract for the sale of the following goods and/or provision of the following services:

Type of service(s) and description of the service(s) (include, if applicable, the reference number):

Date on which the order was placed or subscribed:

Name and identity document (DNI/NIE/Passport) of the consumer(s) and user(s) (copy attached):

Address of the consumer(s) and user(s):

Telephone of the consumer(s) and user(s):

E-mail address of consumer(s) and user(s):