To the attention of IKOULA, SAS, 2 Cité Paradis 75010 Paris – France

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 the consumer(s):

Address of the consumer(s):

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

Date:




(*) Delete as appropriate.