Cancellation Form

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

To UK Vapour Brands Limited, t/a The Electronic Cigarette Company of The Old Fire Station, Manchester Road, Accrington, Lancashire, BB5 2BH and info@theelectroniccigarette.co.uk :

I/We [*] hereby give notice that I/We [*] cancel my/our [*] contract of sale of the following goods:

Order Number:

Ordered on: _____________________ /received on _______________________,

Name of consumer(s),

Address of consumer(s),

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

Date

[*] Delete as appropriate

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