Template for detachable slip
Withdrawal slip
To be returned no later than fourteen days after the date of your acceptance of the credit agreement.
Where the credit is used exclusively to finance the supply of specific goods or the provision of specific services, as specified in the credit agreement, and you have opted, by means of a signed and dated written request, for the immediate delivery or provision of the goods or services, this withdrawal period expires on the date on which the goods are delivered or the service provided, but may not exceed fourteen days or be less than three days, except in the case of doorstep sales or canvassing : in this case, the withdrawal period is fourteen days, regardless of the date of delivery of the goods.
The period begins to run on the day you accept the offer of a credit agreement.
This withdrawal is valid only if it is sent, legibly and fully completed, by registered letter with acknowledgement of receipt (1), to (identity and address of the lender), before the expiry of the abovementioned periods.
I, the undersigned (*), ……………………, hereby renounce the offer of credit of (*) ………………… euros that I accepted on (*) ……………….. for the purchase of (*) (2) ……………….. (specify the item purchased or service provided) from (*) (2) (seller or service provider, name and town).
Date and signature of the borrower (and co-borrower if applicable).
(*) Handwritten by the borrower. (1) Optional. (2) When the credit is used exclusively to finance the supply of specific goods or the provision of specific services mentioned in the credit agreement.