Withdrawal Form

(If you wish to withdraw from the contract, please complete this form and return it.)

---

To:

WIM Michał Olejarz
Rondo Daszyńskiego 2B
00-843 Warsaw
Poland

E-mail: sales@steel-containers.com

---

I/We () hereby give notice that I/we () withdraw from the contract of sale of the following goods:

.

.

Ordered on () / received on ():

.

.

Name of consumer(s):

.

.

Address of consumer(s):

.

.

.

.

Signature of consumer(s) (only if this form is notified on paper):

.

Date:

.

(*) Delete as appropriate.