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(Please print, complete and return the form to the following address: Row & Ma 6 rue d'Armaillé, 75017 Paris


I, the undersigned Mrs / Mr ____________________________________ Residing in:


City :

Postal code :


Telephone number (landline or mobile):

E-mail :

Hereby notifies Row & Ma, SAS registered with the RCS of Paris under number 888 831 773 whose registered office is located at :

6 rue d'Armaillé, 75017 Paris - France, of my withdrawal from the contract for the sale of the / of the goods below:


Order number :

Date of receipt of the order:

Delivery address (if different from the buyer's address):


Date :                       

Signature :

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