Model Withdrawal Form

Complete and return this form only if you wish to withdraw from a purchase. Using this form is not obligatory; you may also withdraw by any other clear statement.

To: Patrick van der Pijl, Olympisch Stadion 24-28, Unit 2.02, 1076 DE Amsterdam, Netherlands.

Email: patrick.van.der.pijl@businessmodelsinc.com

I/We hereby give notice that I/We withdraw from my/our contract of sale of the following goods:

___________________________________________________________________

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:  ____________________________________________________________