MODEL WITHDRAWAL FORM
Complete and send this form only if you wish to withdraw from your contract.
Using this form is optional: any clear statement of withdrawal is sufficient.

To: CoCha Consulting AB (YourLyricVideo)
Vetenskapens gränd 12
431 53 Mölndal, Sweden
Email: kontakt@cochaconsulting.se

I/We (*) hereby give notice that I/We (*) withdraw from my/our (*) contract
for the provision of the following service / digital content (*):

________________________________________________________________________

Order reference (if available): __________________________________________

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

Name of consumer(s): ____________________________________________________

Address of consumer(s): _________________________________________________

________________________________________________________________________

Email for acknowledgement (optional): ___________________________________

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

________________________________________________________________________

Date: __________________________________________________________________

(*) Delete as appropriate.