The form referred to in the second paragraph of I of article L. 341-16, which is entitled “Form relating to the withdrawal period provided for in article L. 341-16 of the Monetary and Financial Code”, includes the following information:
1° A statement to the effect that this form must be returned no later than 14 days from the conclusion of the contract by registered letter with acknowledgement of receipt;
2° The identity of the organisation with which the contract has been concluded, its address and the designation of the contract, among the categories mentioned in article L. 341-1 of the Monetary and Financial Code, subject to the prohibitions provided for in article L. 341-10 and the exceptions provided for in III of article L. 341-16;
3° A statement to the effect that the withdrawal is valid only if it is sent legibly and duly completed before expiry of the 14-day period provided for in article L. 341-16;
4° A statement to the effect that the person canvassed declares that he renounces the contract, with a description of the product or service offered for which he signed the contract;
5° The name of the organisation that marketed the product or service and with which the canvassed party entered into the contract;
6° The date and signature of the customer and, where applicable, of the other contracting parties.