Model Withdrawal Form

(If you wish to withdraw from the contract, please fill out this form and send it back.)

To:
Codes of Life LLC
3833 Powerline Rd, Suite 102-A
Fort Lauderdale, FL 33309, United States
Email: info@codesoflife.com

I/we (*) hereby give notice that I/we (*) withdraw from my/our (*) contract for the purchase of the following goods (*) / the provision of the following service (*): ________________________________________

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

Invoice or order number (optional): ________________________________________

Name of consumer(s): ________________________________________

Address of consumer(s): ________________________________________

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

Date: ________________________________________

(*) Delete as appropriate.