Form for dissolution / revocation
Only complete this form and return it if you want to cancel / revoke the agreement.
To: Belleza Fashion Boutique (hereinafter referred to as "Belleza"), Voorstraat 5, 3512 AH, Utrecht
I / We (*) share / share (*) hereby inform you that I / we (*) revoke / revoke our agreement regarding the sale of the following goods / delivery of the next service (*) (*)
Signature of consumer (s)
[only when this form is submitted on paper]
(*) Strike out what does not apply.