Right of Withdrawal Form

To Maison Noctya,
Email: contact@maison-noctya.com

I hereby notify you of my withdrawal from the contract for the sale of the following goods:

• Product ordered:
• Order number:
• Ordered on:
• Received on:
• Customer name:
• Customer address:
• Email used for the order:

Date:
Customer signature, only if submitting a paper form: