Withdrawal form

(Complete and return this form only if you wish to withdraw from the contract.)

To: Jake I. Henderson, 847 Overlook Circle
Poughkeepsie, NY 12601, support@abrolume.com

I/We (*) hereby give notice that I/We (*) withdraw from my/our (*) contract of sale of the following goods (*):

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

Order number:

Name of consumer(s):

Address of consumer(s):

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

Date:

(*) Delete as appropriate.