OPTIONAL MODEL WITHDRAWAL FORM

Complete and send this form only if you wish to withdraw from a contract
to which the withdrawal right applies.

To:
VYRENQO
12 rue des Chevaucheurs
69005 Lyon, France
business@vyrenqosoftware.tech

I/We (*) hereby notify you that I/We (*) withdraw from my/our (*) contract
for the following service or digital content/service:

Description of the service: ________________________________________
___________________________________________________________________

Quotation or contract reference: ___________________________________
Contract concluded on: _____________________________________________

Name of consumer(s): _______________________________________________
Address of consumer(s): ____________________________________________
___________________________________________________________________
Email address for a reply (optional): _______________________________

Date: _____________________________________________________________
Signature of consumer(s), only if this form is notified on paper:
___________________________________________________________________

(*) Delete as appropriate.

You may instead send an unambiguous withdrawal statement by email
without using this model. Keep evidence of notification.
Do not include payment-card details or passwords.