Application for refusal

Opt-out form

Date: _______________

Seller's name: Limited Liability Company "VESSPO"

Seller's (actual) address: Riga, Brīvības iela 155 k-4, LV-1012

Seller's phone number: +371 67360330

Seller's e-mail address:

Name, surname of the consumer: ________________________________________

Consumer address: ________________________________________

Product Name: ____________________________________

Date of product purchase: ________________________________________

Date of receipt of the product: ________________________________________

Proof of purchase: ________________________________________

Consumer notice of withdrawal: I hereby declare that I wish to withdraw from the contract I have entered into for the purchase of the above item.

Signature of the consumer: ____________________

Please send a completed right of refusal form together with a copy of the purchase document to

Within 14 days, please send or deliver the received product to SIA "Vesspo" sales point, store "CeĆotājs" Brīvības street 155 k-4, Riga, LV-1012.

Complete and send this form only if you wish to withdraw from the contract.