Addressed to IKOULA NET, 2 Cité Paradis, 75010 Paris

I/We (*) hereby notify you (*) of my/our (*) withdrawal from the contract for the sale of the goods (*) / for the provision of the services (*) below:

Ordered on (*) / received on (*):

Name of consumer(s):

Address of consumer(s):

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

Date:




(*) Delete as appropriate.