Model withdrawal form (complete and return this form only if you wish to withdraw from the contract) To: MT SOFTWARE CONSULTING SRL, București, Șos. Vitan-Bârzești 9A, corp E, sector 4, România, e-mail contact@be-loud.eu 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