Withdrawal form

At

Wallbox Discounter B.V.

Herinckhavestraat 5

7557 JJ Hengelo

Tel. +31 74 700 2114

Email: [email protected]

I/we hereby revoke the contract concluded by me/us* for the purchase of the following goods:

Article:

__________________________________________________

Article description:

__________________________________________________

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

__________________________________________________

Consumer's first and last name:

__________________________________________________

Address of the consumer:

__________________________________________________

Date, signature:

__________________________________________________

(*) Please delete what does not apply 

Wallbox Discounter B.V.
Herinckhavestraat 5
7557 JJ Hengelo

Tel. +31 74 700 2114
Email: [email protected]
Internet: www.wallboxdiscounter.com/en
Commercial register number: 77330889
VAT identification number: NL860973475B01
Managing Director: Coen Denkers