Terms of using


Rules of remote sales of goods and rendering electronic services
 

§ 1
Introduction


These rules define the principles and terms of using the online shop made available at www.gpower.pl website by Rafał Głażewski, conducting a business activity under the name of G’Power Rafał Głażewski, ul. Harcerska 3, 66-400 Gorzów Wielkopolski, with a NIP (Tax ID) number 5992270394, entered into the Register of Entrepreneurs - Central Records and Information on Economic Activity (CEIDG) kept by the competent minister for economic affairs, and in particular define the principles of placing Orders and concluding sales agreements and other agreements within the Website, with the use of means of remote communication, as well as the Customers' taking advantage of services made available by the Seller via Online Shop.

Data for quick communication with the Seller (Address / contact / complaint data): 

Contact details: 

G'POWER Sp. z o.o.

ul. Harcerska 3
66-400 Gorzów Wlkp.
NIP: 599-320-38-79
Regon: 367433967
KRS: 0000679863

e-mail address: info@gpower.pl
phone no.: +48 883 442 244

 

§ 2
Glossary


Terms used in these Rules shall have the following meaning: 

  1. Customer – a natural person, including the Consumer, who is at least 13-years old, as well as a legal person or organizational unit not being a legal person, to whom the specific provisions have granted a legal capacity, and who has placed or intends to place the Order or take advantage of other services of the Online Shop;
  2. Account (User Account) - functionality of the Website, under which the Customer, after Registering, has a possibility to use the functionality [unavailable to non-registered (not having the Account) Users] and the Services of the Website; To effectively create the Account the User must read and accept the Rules; the User may create the Account under the functionality of the Website, entering the data required by the Seller in the course of the Registration process; creating the Account is tantamount to conclusion of the Agreement for rendering electronic services;
  3. Consumer - a natural person performing a legal act not directly related to their business or professional activity;
  4. Rules - these Rules of sales with the use of remote communication means and rendering of electronic services. Within the scope of electronic services, the Rules shall mean the rules referred to in art. 8 of the act on rendering electronic services dated 18 July 2002;
  5. Registration – voluntary and free of charge activity, consisting in the Customer's creation of the Customer’s Account, conducted based on the messages presented to the Customer as well as on the data entered by the Customer, including personal details, with the use of an administrative panel made available by the Service Provider on the Shop website; 
  6. Online Shop (hereinafter referred to as “Shop” or “Website”) - a website available at www.gpower.pl through which the Customer can place Orders, as well as use the remaining Services of the Website;
  7. Party - Service Provider or Customer;
  8. Goods – movable items being the subject of the Sales Agreement;
  9. Sales agreement - sales agreement within the meaning of the Civil Code Act, concluded between the Service Provider and the Customer with the use of remote communication means via Shop, the subject of which are Goods under the principles specified in the Rules;
  10. Service (Services) - a service provided by the Service Provider via electronic means under the principles specified in the Rules via the Shop;
  11. Service Provider (also “Seller”) - Rafał Głażewski, conducting business activity under the name of G’Power Rafał Głażewski, ul. Harcerska 3, 66-400 Gorzów Wielkopolski, with a NIP (Tax ID) number 5992270394, entered into the Register of Entrepreneurs - Central Records and Information on Economic Activity (CEIDG) kept by the competent minister for economic affairs;
  12. Act – act on consumer rights dated May 30, 2014 (Journal of Laws of 2014, item. 827);
  13. Order - Customer’s declaration of intent on concluding the Sales Agreement with the Service Provider remotely via Online Shop, specifying the type and number of Goods constituting the subject of the Sales Agreement.

 

§ 3
Basic obligations of the Parties

 

  1. Each Party to the Sales Agreement shall be obligated to perform its service, i.e. to implement the concluded Sales Agreement. 
  2. The Customer shall be obligated to use the Shop and Services offered by the Service Provider in a manner compliant with the regulations of the law in force in the Republic of Poland, provisions of the Rules, as well as not to provide contents prohibited by the commonly applicable law regulations.
  3. The Seller shall be obligated to provide the Goods free from defects.
  4. The Service Provider shall be obligated to provide Services in accordance with the provisions of law and the provisions of the Rules.
  5. If the Consumer is a buyer, the Seller shall be obligated to immediately issue the item to the buyer, no later than thirty days from conclusion of the Sales Agreement, unless the Sales Agreement provides otherwise (different date is specified in the description of the Goods, summary or confirmation of the Order).

 

§ 4
Orders

 

  1. The Customer may place the Orders via Online Shop 7 days a week, 24 hours a day. 
  2. Having the Account on the Website is not required to place the Order and conclude the Sales Agreement. 
  3. In order to conclude the Agreement for the sale of Goods remotely via the Online Shop, one should select the Goods, login to the Account or place the Order without the Account, by entering the necessary data required by the Seller during the process of placing the Order and finally place the Order by performing further activities based on information and messages displayed to the Customer.
  4. To place an effective Order and effectively conclude the Sales Agreement the Customer must read and accept the Rules and confirm that the Customer is aware of the fact that placing the Order entails a payment obligation.
  5. After placing the Order, the Customer receives an e-mail message confirming that the Order has been received by the Shop, containing the final confirmation of all relevant elements of the concluded Sales Agreement. The Customer, by clicking the relevant link and thereby confirming the order, concludes the Sales Agreement.

 

§ 5
Prices, payments and delivery of Goods

 

  1. Prices of Goods in the Shop are given in EURO and they are gross prices.
  2. Prices of Goods do not include the costs of delivery. Total value of the Order includes the price of Goods as well as the costs of delivery, in case when the costs of delivery are borne by the Customer.
  3. Delivery shall be performed via courier companies or post office.
  4. The Customer has the possibility to pay the price in the following manner: 
  • traditional bank transfer to the Seller’s account;
  • on delivery – cash on collection of Goods,
  • via website ……………. made available by DOTPAY;
  1. The costs of delivery are indicated on the subpage of the Shop after indication of the delivery address.
  2. Delivery of Goods shall be performed both on the territory of the Republic of Poland and outside its borders, acc. to the delivery price list. In case of payment on delivery, the Goods shall be shipped only within the Republic of Poland.
  3. Shipment of Goods takes place on the next working day after crediting the Seller’s bank account, with exclusion of payment on delivery - then the Goods are shipped immediately.
  4. Shipment depends on the availability of goods in stock. In case of the lack of goods in the warehouse - shipment takes place within 14 days from the day of submitting the order. Collection of the shipment
  5. At collection of the shipment with the ordered Goods, it is suggested the Consumer to check the delivery, and at least its external condition.
  6. The Seller reminds, that according to art. 791 of the Civil Code, as a result of payment of the carrier’s receivables and acceptance of delivery without objections, any claims against the carrier resulting from the contract of carriage (including those concerning the responsibility for damages) expire. However it does not apply to claims under invisible damages of the shipment, if the recipient, within a week from the moment of acceptance of the shipment, notified the carrier about them.
  7. In connection with the above mentioned provisions in sec. 9, in case of finding mechanical damage to the packaging of the shipment or other damage visible from the outside, we suggest to request the carrier to prepare a protocol indicating the damages. We also suggest to check the content of the shipment each time, and in case of finding:
    • mechanical damage of the content of the shipment,
    • inconsistency of the shipment content with the subject of the Sales Agreement,
  8. The Consumer shall have the right to refuse the acceptance of the shipment. If this is the case, we suggest to write down the comments and notes from the event in the presence of deliverer and immediately inform the Service Provider about the existing situation. Each time, in case of damages we suggest to prepare a protocol of damages in the presence of the deliverer of the shipment. 

  9. The Customer who is not the Consumer at the time of collection of delivery shall be obligated to check its content. In case of finding that it is damaged, he/she shall be obligated to notify this fact to the deliverer of the Goods and immediately contact the Seller.
  10. The Seller reminds that according to art. 548. § 1 of the Civil Code at the time of issuance of the sold item, benefits and burdens associated with the item (Good) as well as the risk of accidental loss or damage of the item (Good) shall transfer to the buyer (Customer).
  11. If the Goods are to be shipped by the Seller to the Consumer, the risk of accidental loss or damage of the Goods shall transfer to the Consumer at the time of issuance of the Goods to the Consumer. Issuance of Goods shall be understood as entrusting it with the carrier by the Seller, if the Seller did not have an influence to the Consumer’s selection of the carrier.

§ 6
The Consumer’s power to withdraw from the Agreement (return of Goods)

  1. The Consumer may withdraw from the Agreement for the sale of Goods concluded remotely without giving any reason, submitting the appropriate written statement, within 14 (fourteen) days, and this period starts upon taking possession of the item by the Consumer or the third person indicated by him/her (other than the carrier), and in case of agreement which includes numerous items, which are delivered separately, in lots or in pieces - upon taking possession of the last item, lot or piece. To maintain the deadline it is sufficient to send the appropriate statement before its expiry to the Seller’s address. 
  2. Statement referred to in sec. 1 above may be submitted also on the form, the specimen of which constitutes the appendix no. 2 to the Agreement and the appendix no. 1 to the Rules.
  3. In the event of withdrawal from the Agreement for the sale of Goods concluded remotely, the agreement is considered null and void. 
  4. If the Consumer had submitted the declaration of withdrawal from the Sales Agreement before the Seller accepted his/her offer, the offer ceases to be binding.

Consumer’s obligations
  1. The Consumer shall be obligated to immediately, however not later than within 14 days from the date on which he/she withdrew from the Sales Agreement, return the Goods to the Seller or give it to a person authorized by the Seller to collect it, unless the Seller has proposed to collect the Goods himself. To maintain the deadline it is suffice to send the Goods back before its expiry. Goods shall be packed in a manner which guarantees its safe transport.
  2. The Consumer bears the costs of the return of Goods (the costs of returning).
  3. The Consumer is liable for any diminished value of the Goods arising from its use beyond the what is necessary to establish the nature, characteristics and functioning of the Goods.

Seller’s obligations
  1. The Seller shall immediately, not later than within 14 days from the date of receipt of the Consumer’s declaration of withdrawal from the Sales agreement, return to the Consumer all the payments made, including the costs of delivery of Goods, and if the Seller has not proposed that he/she shall collect the Goods from the Consumer personally, he/she may withhold the reimbursement of payments received from the Consumer until receipt of the item, or until the Consumer supplies evidence of its return, depending on which event occurs first.
  2. The Seller shall refund payments using the same method of payment that was used by the Consumer, unless the Consumer has expressly agreed to a different method of reimbursement, which is not connected with any costs for him. 
  3. If the Consumer has chosen the method of delivery of the Goods other than the cheapest usual delivery offered by the Seller, the Seller is not obligated to refund the Consumer the additional costs incurred by him.
  4. We suggest to include the proof of purchase in order to improve the process of return. 

Statutory exclusion of the right to withdraw from the Sales Agreement
  1. The right to withdraw from the agreement shall not be granted in situations specified in art. 38 of the Act, i.e. in relation to the following agreements:
  • for the provision of services if the entrepreneur performed the service in its entirety at the express consent of the consumer, who was informed before commencing the service that upon its provision by the entrepreneur he shall lose the right to withdraw from the agreement; 
  • in which the price or remuneration depends on fluctuations in the financial market over which the entrepreneur has no control, and which may occur before the date of withdrawal from the agreement; 
  • in which the subject of the service is a non-fabricated item, manufactured according to the specifications of the consumer or used to satisfy personalized needs; 
  • in which the subject of the service is an item that undergoes rapid decay or having a short shelf life; 
  • in which the subject of the service is an item delivered in a sealed container, which after opening cannot be returned due to health protection or hygiene reasons, if the package was unsealed after delivery; 
  • in which the subject of the service are items that, after delivery, due to their nature, are inextricably linked with other things; 
  • in which the subject of the service are alcoholic beverages, whose price was agreed at the conclusion of the sales agreement and the supply of which can only take place after 30 days and the value of which depends on fluctuations in the market, over which the entrepreneur has no control; 
  • in which the consumer has specifically demanded that the entrepreneur come to him in order to perform urgent repairs or maintenance; if the entrepreneur provides additional services other than those which were requested by the consumer or delivers items other than spare parts that are necessary for repair or maintenance, the right to withdrawal is granted to the consumer in reference to additional services or objects; 
  • in which the subject to the service are audio or video recordings or computer software delivered in a sealed package, if the package was opened after delivery; 
  • for the delivery of newspapers, periodicals or magazines, with the exception of subscription agreement; 
  • concluded in a public auction;
  • for the provision of services in terms of accommodation other than for residential purposes, the carriage of goods, car rental, catering, services related to leisure activities, entertainment, sport or cultural events, if the agreement specifies the day or period of the performance of the service; 
  • for the supply of digital content which is not stored on a tangible medium if the performance of the service began at the express consent of the consumer before the date of withdrawal from the agreement and after having being informed by the entrepreneur about the loss of the right of withdrawal from the agreement. 

§ 7
Statutory guarantee for physical defects of Goods
(Complaints and claim procedure)

  1. The Seller shall be obligated to provide the Goods free from defects and shall be responsible for the defects of Goods.
  2. Physical defect consists in inconsistency of the sold Goods with the Sales Agreement. 
  3. Claims under the warranty on defects (inconsistency of Goods with the Sales Agreement) can be also submitted in writing or via e-mail to the Seller’s address.
  4. The Customer, who exercises the powers under the warranty, should deliver the defective Goods to the Seller.
  5. In order to accelerate the complaint process, one should specify in the content of the complaint: the reported complaint, short description of reasons justifying the complaint and contact details of the Consumer. If possible please attach the evidence of purchase of Goods to the complaint (an invoice or receipt). In case when the complaint does not contain information necessary to consider the complaint, the Seller shall contact with the Customer in order to obtain them.
  6. If the sold Good has a defect, the Customer can:
  • submit a statement for price reduction or withdrawal from the agreement, unless the Seller replaces the defective Goods for ones free from defects or if defects are removed promptly and without undue inconvenience for the Customer. Reduced price should remain in such proportion to the price resulting from the agreement, in which the value of Goods with defects remains in relation to the Goods without the defect. The Customer cannot withdraw from the agreement if the defect is immaterial;
  • request replacement of Goods for ones that are free from defects or for removing the defect. The Seller shall replace the defective Goods for ones that are free from defects or remove the defect within the reasonable time without undue inconvenience for the Customer, subject to and on the rules specified in the relevant principles of the Civil Code.
  1. If the Client is a Consumer, he may instead of the removal of the defect proposed by the Seller request to replace the Goods for one that is free from defects or instead of replace the Goods request the removal of the defect, unless bringing the Goods to compliance with the sales agreement in a manner chosen by the Consumer is impossible or would require excessive costs in comparison to the method proposed by the Seller. When assessing these costs, the value of Goods free from defects is taken into account and the extent of the defect, as well as inconvenience which the Consumer would be exposed to by a different method of satisfaction.
  2. In case of sale between the entrepreneurs, the buyer (the Customer not being a Consumer) losses the powers under the warranty if he failed to inspect the Goods at a time and in manner that are adopted for items of this type and has failed to immediately inform the Seller about the defect, and in case when the defect emerged later - if he failed to notify the Seller immediately after discovery.
  3. The Consumer shall be notified about the consideration of complaint and the method of its execution within 14 days.
  4. The Seller shall be responsible for the inconsistency of the Goods with the agreement only in case of its discovery before the expiry of two years since the release of these Goods to the Consumer. The Consumer shall loss his entitlements, under the applicable provisions, to request bringing the Goods to the state compliant with the agreement, if he fails to notify the Seller before the expiry of twelve months from discovery of inconsistency of the goods with the agreement. To maintain the deadline it is suffice to send the notification before its expiry.

§ 8
Quality assurance of Goods


  1. Quality assurance may be granted on Goods. Granting the assurance takes place through submitting a warranty statement, which specifies the obligations of the guarantor and rights of the buyer in case when the sold item does not have the properties specified in this statement.
  2. The warranty for oars from the category:
  • Sprint, Dragon Boat, Wildwater SUP and Outrigger is 24 months,
  • Slalom, Kayak Polo and Freestyle - is 12 months.

Warranty terms
  1. The warranty is valid only when:
  • an oar is used in compliance with age category and its intended use;
  • an oar was assembled in accordance with the operation manual
  • an oar has not stayed in the sun or in places where the temperature exceeded 60°C for a long time
  • a serial number is visible and legible, unless the lack of a number is the fault of the Seller;
  • Qnect connection system is appropriately maintained;
  1. The warranty does not cover mechanical defects caused as a result of improper use.
  2. The condition necessary to recognize the complaint under the warranty is the manufacturer’s confirmation of a manufacturing defect of the Goods.
  3. In order to handle the complaint under the warranty, it is necessary to perform an expertise at the seat of a company and send the oar back to the following address:
      G'POWER 
      ul. Harcerska 3,
      66- 400 Gorzów Wlkp.
      Poland
  1. In case of a positive recognition of the complaint under the warranty, the Seller sends back the repaired or replaced oar (Goods) to the customer’s address and bears the costs of shipment.
  2. Maintenance
  • When the kayak oar is used in a fresh water, it has to be disassembled and cleaned once a week.
  • When the kayak oar is used in a salt water, then it is recommended to disassemble and clean it after every use.
  • Failure to apply the above advices may lead to damage the Qnect connection.
  1. If the warranty has been granted for the quality of the sold item, in case of any doubts, it shall be considered that the guarantor is obligated to remove the physical defect of the item or to deliver the item free from defects, if these defects emerge within the deadline specified in a warranty statement.
  2. The Customer may execute the rights under the warranty for physical defects of item notwithstanding the rights resulting from the warranty.
  3. Execution of the rights under the warranty does not affect the Seller’s liability under the warranty.  However, in case of execution of the rights under the warranty by the Customer, the period for execution of rights under the warranty is subject to suspension as of the date of notification of the Seller about the defect. This period continues to run from the date of the guarantor’s refuse to execute the obligations under the warranty or ineffective expiration of the period for their execution.
  4. When executing the rights under the warranty, one should deliver the Goods to the place indicated in the warranty.
  5. The guarantor shall be obligated to execute his obligations within the period specified in the content of a warranty statement, and if not specified - immediately, but no later than within 14 days, counting from the date of delivery of an item by the person entitled under the warranty.

§ 9
Personal details

 
  1. Personal details of Customers are processed by the Seller with taking into account the provisions of law within this scope, in particular of the personal details protection act dated August 29, 1997. 
  2. The administrator of the Customer’s personal details is the Seller.
  3. Providing personal details is voluntary, however the failure to provide the required personal details may prevent the possibility to place the Order. 
  4. Any personal details made available are particularly protected. 
  5. Each person has the right to access the contents of their personal details, as well as to demand to update them or stop their processing. 

§ 10
General terms of using the Online Shop

  1. The Service Provider, via the Online Shop, provides the following Services: 
  • presentation of the Shop assortment, 
  • possibility to place the Orders for Goods available on the Online Shop and the same time the possibility to conclude Sales agreements remotely, 
  • download the Operation Manuals;
  • use the Customer’s Account,
  • placing comments under the Goods in the Website. 
  1. Access to services specified in sec. 1 item 1-2 above does not require the Registration.
  2. Access to services specified in sec. 1 item 3-5 above requires the Registration.
  3. Using the services specified in sec. 1 is free of charge. 
  4. To use the Shop the Customer is required to have a device with an access to the Internet, equipped with an Internet browser (Mozilla Firefox at least 24.0 version, Opera at least version 10, Google Chrome in 28.0 version or higher or MS Internet Explorer in version at least 8.0 or higher are recommended), which allows the support of cookie files and Javascript. It is allowed to use other versions of Internet browsers, if they provide full compliance with versions listed above.
  5. The Customer can give a consent for receiving commercial information, i.e. has a possibility to order the Newsletter - a service provided by the Service Provider. Newsletter is send only to the Customers who ordered the Newsletter.
  6. Within the frames of Newsletter service, the information in the form of an e-mail, containing an information bulleting (Newsletter) of the Internet Shop as well as other commercial information sent by the Service Provider on its behalf or on behalf of third parties are sent, via e-mail, to the e-mail address specified by the Customer,
  7. The Customer has the right to cancel the Newsletter subscription at any time. 

§ 11
Judicial settlement of disputes

  1. Settlement of possible disputes arising between the Service Provider and the Customer, who is the Consumer shall be subjected to the competent courts according to the relevant provisions of the Code of Civil Procedure.
  2. Settlement of any disputes arising between the Service Provider and the Customer who is not a Consumer shall be subjected to the competent court for the seat of the Service Provider.

§ 12
Extrajudicial means of handling complaints and redress 
and rules of access to these procedures

  1. Should the Seller refuses to honor the Consumer’s complaint, and the Consumer does not agree with the decision of the Seller, he can ask for mediation or settlement to the arbitral tribunal, therefore he can use the alternative methods of settlement of disputes (ADR - Alternative Dispute Resolution).
  2. The use of ADR is possible only after:
  • completion of the complaint process (one should submit the complaint firstly to the Seller), and
  • the consent of both parties for procedure within the frames of ADR (if one party does not give a consent for ADR procedure it is not possible to apply it - then the option of legal proceeding remains).
  1. Detailed information about the extrajudicial method of pursuing the claims can be found in the guide of Offices of Competition and Consumer Protection on the following link: http://www.uokik.gov.pl/download.php?plik=15038
  2. Detailed information on the possibility of the Customer who is a Consumer to use extrajudicial methods of handling complaints and redress and rules of access to these procedures are available in seats and on the websites of poviat (municipal) consumer advocates, social organizations whose statutory tasks include the protection of consumer rights, Voivodeship Inspectorates of Trade Inspection and the following Internet addresses of Offices of Competition and Consumer Protection:
    http://www.uokik.gov.pl/spory_konsumenckie.php
    http://www.uokik.gov.pl/sprawy_indywidualne.php
    http://www.uokik.gov.pl/wazne_adresy.php
  1. Customer who is a Consumer has, among others, the following possibilities of using extrajudicial methods of handling complaints and redress:
  • Available from February 15, 2016 platform for settlement disputes online (Online Dispute Resolution) available on the website http://ec.europa.eu/consumers/odr/ 
  • Regular consumer arbitration court running at Trade Inspection - the possibility to request to settle the dispute arising from the concluded Sales Agreement;
  • provincial commercial inspection inspector the possibility to request to initiate mediation proceedings on the amicable settlement of a dispute between the Client and shop;
  • district (municipal) consumer advocate or social organization whose statutory tasks include consumer protection (for instance the Consumer Federation, Association of Polish Consumers). Advice is provided by the Consumer Federation at the toll free consumer helpline 800 007 707 and by the Association of Polish Consumers at e-mail address porady@dlakonsumentow.pl

§ 13
Final Provisions

 
  1. In matters not regulated herein the generally applicable provisions of law apply. Sales agreement and other agreements concluded based on these Rules shall be concluded according to the Polish law provisions and thus the Polish law is applicable for execution of the Sales agreement and agreement for rendering electronic services. 
  2. Customers may obtain the access to the Rules at any time, free of charge via sub-page (tab) of the Shop - Rules, available from any level in the Shop.
  3. Information on the Goods given in the Shop, in particular their descriptions, technical and functional parameters as well as prices, constitute the invitation to conclude the agreement within the meaning of the art. 71 of the Civil Code.
  4. Change of the Rules may take place with maintaining the terms specified in art. 3841 of the Civil Code.
  5. Rights to any contents made available within the frames of Online Shop, and in particular copyrights to pictures, descriptions of Goods, the name of the Shop, trademarks attributable to the Service Provider and the manufacturers of Goods, graphical elements included in the Shop, software as well as rights within the scope of databases are protected by law and are attributable to the Service Provider or entities with which the Service Provider concluded relevant agreements. Copying or other forms of using any elements of the Shop without the consent of the Service Provider are forbidden, and the infringement of the above mentioned laws is subject to criminal liability, including the custodial sentence.

§ 14

Criminal liability
  
  1. The use of these Rules in whole or in any part constitutes infringement of copyrights of authors and is subject to criminal liability, including the custodial sentence based on provisions of art. 115 et seq. of the Act dated February 4th 1994 on copyright and related rights.
  2. In case of discovery of sharing these Rules in whole or in any part, the authors will undertake any available legal means in order to determine the liability of relevant persons, and in addition to criminal liability of person infringing, will also claim the compensation from these persons.



Appendix no. 1 to the Rules


Specimen of the form for withdrawal from the Sales agreement
(this form should be completed and sent only in case of willingness to withdraw from the agreement)

Date: ……………………………………………………

Addressee:
G'POWER Sp. z o.o.
ul. Harcerska 3
66-400 Gorzów Wlkp.
Poland
e-mail address: info@gpower.pl
phone no.: + 48 883 442 244


I hereby inform of my withdrawal from the sales agreement for the following items:
 
………………………………………………………………………………………………………………………………….………


Date of receipt of Goods: ……………………………………………………………………………………………………………………..
Consumer’s full name: ……………………………………………………………………………………………………………
Consumer’s address:  …………………………………………………………………………………………………………………………



………………………………….
Consumer's signature (only if this form is sent in paper form)