Complete and return this form only if you wish to withdraw from the contract to:

Dr. Eveline Riedling EPU
Meidlinger Hauptstrasse 7-9/3/10
1120 Vienna
Austria

or

by mail with the contact form of the Cellarium website

I hereby give notice that I withdraw from my contract of sale of the following goods / for the provision of the following service (delete as appropriate):

Ordered on:

Received on:

Name of consumer:

Address of consumer:

Goods already received will be returned to the following address:

Dr. Eveline Riedling EPU
c/oMYPLACE - Riedling
Hietzinger Kai 79
1130 Vienna Austria

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

Date: