Declaration of withdrawal

RETURN ACCEPTANCE PROTOCOL

address: SIA „Helios DSC”, Semināra 19-3, Valka, Latvia, LV-4701

……………………………………………………               ……………………………………………………

                                City Date

Order No. …………

Proof of purchase number ………………………………………………………………………………..

Name and surname……………………………………………………………

Address……………………………………………………               ……………………………………………………

Contact phone number……………………………………………..

Date of conclusion of the sales contract………………………………………………………………..

I withdraw from the purchase / Return

I declare that I return the purchased product in an unchanged state. I have attached a proof of purchase with the product I purchased to my shipment. Please transfer the total amount of the refund to the account below.

*reasons for returns:

  • 1. DOES NOT FIT SIZE (TOO SMALL/TOO BIG)
  • 2. DEFECTIVE PRODUCT
  • 3. SIZE NOT COMPATIBLE WITH DIMENSION TABLE
  • 4. CUT NOT FOR ME
  • 5. PRODUCT QUALITY
  • 6.OTHER (WHAT?)

I withdraw from the purchase / Return

1………………………………………………………………………    REASON*…………

2………………………………………………………………………    REASON*………….

3………………………………………………………………………    REASON*…………

4……………………………………………………………………….   REASON*…………

5……………………………………………………………………….   REASON*…………

 (Name of returned item )                                                                            ( enter the number of the reason for the return)

……………………………………………              

                         Amount to be refunded

                                                   

Bank account number

Bank Name:…………

Name and surname of the bank account holder: ……………….

    legible signature of the person returning the signature of the person receiving the goods

…………………………………………………………….                                …………………………………………………………..