Model withdrawal form — Diaspeak

Use only if you want to withdraw from the contract. This model is optional; any unambiguous statement is acceptable. If your seller is a store, replace the recipient with the one identified on your receipt.

To Reda Sahraoui — Diaspeak, 59 route d’Allauch, 13011 Marseille, France, contact@diaspeak.com.
I hereby give notice that I withdraw from my contract for the following service: Diaspeak Premium subscription [plan].
Ordered on: […]
Consumer’s name: […]
Consumer’s address: […]
Date: […]
Consumer’s signature, only for a paper submission: […]