1 – Definitions
2 – Identity of the entrepreneur
3 – Applicability
4 – The offer
5 – The contract
6 – Right of withdrawal
7 – Obligations of the consumer during the reflection period
8 – Exercise of the right of withdrawal by the consumer and costs
9 – Obligations of the entrepreneur upon revocation
10 – Exclusion of right of withdrawal
11 – The price
12 – Compliance and additional warranty
13 – Delivery and execution
14 – Duration transactions: duration, termination and extension
15 – Payment
16 – Complaints Procedure
17 – Disputes
18 – Branch guarantee
19 – Additional or deviating provisions
20 – Modification of the general terms and conditions of the Stichting Webshop Keurmerk
Article 1 – Definitions
In these conditions:1. Additional agreement: an agreement whereby the consumer products, digital contentand / or acquires services in connection with a distance contract and these goods, digital content and / or services are provided by the entrepreneur or by a third party on the basis of an agreement between that third party and the entrepreneur;2. Cooling-off period: the period within which the consumer can make use of his right of withdrawal;3. Consumer: the natural person who does not act for purposes related to histrade, business, craft or professional activity;4. Day: calendar day;5. Digital content: data produced and delivered in digital form;6. Term Agreement: an agreement that extends to the regular delivery of goods and servicesand / or digital content during a certain period;7. Durable data carrier: every tool – including e-mail – that the consumeror enables the entrepreneur to store information that is addressed to him personally in a way that future consultation or use during a period that is geared to the purpose for which the information is intended and that allows unaltered reproduction of the stored information ;8. Right of withdrawal: the possibility for the consumer to waive the distance contract within the cooling-off period;9. Entrepreneur: the natural or legal person who is a member of Stichting Webshop Keurmerk and offers products, (access to) digital content and / or services to consumers at a distance; 210. Distance contract: an agreement concluded between the entrepreneur and the consumer in the context of an organized system for distance selling of products, digital content and / or services, whereby up to and including the conclusion of the agreement exclusively or use is made of one or more techniques for distance communication;11. Model form for withdrawal: the European model form for withdrawal included in Appendix I of these conditions;12. Technology for distance communication: means that can be used for concluding an agreement, without the consumer and entrepreneur having to be in the same room at the same time;
- Article 2 – Identity of the entrepreneur
Name entrepreneur: Aveau
- Beneluxlaan 675
- 1363 BJ in Almere
- The Netherlands
Visiting address: no visitings address
E-mail address: email@example.com
Chamber of Commerce number; 69722102
VAT identification number; NL212892794B01
If the activity of the entrepreneur is subject to a relevant licensing system: the details of the supervisory authority;If the entrepreneur has a regulated profession:• – the professional association or organization to which he is affiliated;• the professional title, the place in the EU or the European Economic Area where it is awarded;• – a reference to the professional rules that apply in the Netherlands and instructionsand how these professional rules are accessible.
Article 3 – Applicability
1. These general terms and conditions apply to every offer made by the entrepreneur and to every distance contract that has been established between the entrepreneur and the consumer.2. Before the distance contract is concluded, the text of these general terms and conditions will be made available to the consumer. If this is not reasonably possible, the entrepreneur before the distance contract is concluded, indicate how the general terms and conditions at the entrepreneur can be seen and that they will be sent free of charge as soon as possible at the request of the consumer.3. If the distance contract is concluded electronically, by way of derogation from the previous paragraph and before the distance contract is concluded, the text of these general terms and conditions can be made available electronically to the consumer in such a way that the consumers can be easily stored on a durable medium. If this is not reasonably possible, before the distance contract is concluded, it will be indicated where the general terms and conditions can be consulted electronically and that they will be sent free of charge at the request of the consumer by electronic means or otherwise. 4. In the event that specific product or service conditions apply in addition to these general terms and conditions, the second and third paragraphs shall apply mutatis mutandis and, in the event of contradictory conditions, the consumer may always invoke the applicable provision that is most applicable to him. favorable.
Article 4 – The offer1. If an offer is of limited duration or subject to conditions, this will be explicitly stated in the offer.32. The offer contains a complete and accurate description of the offered products, digital content and / or services. The description is sufficiently detailed to allow a proper assessment of the offer by the consumer. If the entrepreneur uses images, these are a true reflection of the offered products, services and / or digital content. Obvious mistakes or errors in the offer do not bind the entrepreneur.3. Each offer contains such information that it is clear to the consumer what rights and obligations are attached to the acceptance of the offer.
Article 5 – The contract
1. Subject to the provisions of paragraph 4, the agreement is concluded at the moment of acceptance by the consumer of the offer and the fulfillment of the corresponding conditions.
2. If the consumer has accepted the offer electronically, the entrepreneur will immediately confirm electronically the receipt of the acceptance of the offer. As long as the receipt of this acceptance has not been confirmed by the entrepreneur, the consumer can dissolve the agreement.
3. If the agreement is concluded electronically, the entrepreneur will take appropriate technical and organizational measures to secure the electronic transfer of data and he will ensure a secure web environment. If the consumer can pay electronically, the entrepreneur will observe appropriate security measures.
4. The entrepreneur can within statutory frameworks – inform whether the consumer can meet his payment obligations, and of all those facts and factors that are important for a responsible conclusion of the distance contract. If the entrepreneur based on this investigation has good reasons not to enter into the agreement, he is entitled to refuse an order or request, motivated or to attach special conditions to the execution.
5. At the latest upon delivery of the product, the service or digital content, the entrepreneur shall send the following information, in writing or in such a way that it can be stored by the consumer in an accessible manner on a durable medium: a. the visiting address of the business location of the entrepreneur where the consumer can go with complaints;b. the conditions under which and the manner in which the consumer can exercise the right of withdrawal, or a clear statement regarding the exclusion of the right of withdrawal; c. the information about guarantees and existing service after purchase; d. the price including all taxes of the product, service or digital content; insofar as applicable, the costs of delivery; and the method of payment, delivery or execution of the distance contract;e. the requirements for terminating the agreement if the agreement has a duration of more than one year or is indefinite; f. if the consumer has a right of withdrawal, the model form for withdrawal.
4. In the case of an extended transaction, the provision in the previous paragraph only applies to the first delivery.
Article 6 – Right of withdrawal
With products:1. The consumer can terminate an agreement regarding the purchase of a product during a reflection period of at least 14 days without giving any reason. The trader may ask the consumer about the reason for the withdrawal, but not to oblige him to state his reason (s).2. The reflection period referred to in paragraph 1 starts on the day after the consumer, or a third party designated by the consumer in advance, who is not the carrier, has received the product, or:1. if the consumer ordered several products in the same order: the day on which thethe consumer, or a third party designated by him, has received the last product. The entrepreneur may, provided he has informed the consumer in a clear manner prior to the ordering process, refuse an order of several products with a different delivery time.2. if the delivery of a product consists of several shipments or parts: the day on which the consumer, or a third party designated by him, received the last shipment or the last part;
4c. in contracts for regular delivery of products during a certain period: the day on which the consumer, or a third party designated by him, has received the first product.For services and digital content that is not delivered on a tangible medium:3. The consumer can dissolve a service agreement and an agreement for the supply of digital content that has not been delivered on a tangible medium for at least 14 days without giving any reason. The trader may ask the consumer about the reason for the withdrawal, but not to oblige him to state his reason (s).4. The reflection period referred to in paragraph 3 starts on the day following the conclusion of the agreement.Extended cooling-off period for products, services and digital content that has not been delivered on a tangible medium when not informing about the right of withdrawal:5. If the entrepreneur provides the consumer with the legally required information about the right of withdrawal orhas not provided the model withdrawal form, the reflection period will expire twelve months after the end of the original reflection period set in accordance with the previous paragraphs of this article.6. If the trader has provided the consumer with the information referred to in the previous paragraph within twelve months after the commencement date of the original period of reflection, the cooling-off period will expire 14 days after the day on which the consumer has received this information.
Article 7 – Obligations of the consumer during the cooling-off period
1. During the cooling-off period, the consumer will handle the product and the packaging carefully. He will only unpack or use the product to the extent necessary to determine the nature, characteristics and operation of the product. The basic principle here is that the consumer may only handle and inspect the product as he would be allowed to do in a store.2. The consumer is only liable for the value reduction of the product that is the result of a way of handling the product that goes further than allowed in paragraph 1.3. The consumer is not liable for the value reduction of the product if the entrepreneur has not provided him with any legally required information about the right of withdrawal before or at the time of concluding the contract.
Article 8 – Exercise of the right of withdrawal by the consumer and costs thereof
1. If the consumer exercises his right of withdrawal, he shall notify the entrepreneur within the cooling-off period by means of the standard form for withdrawal or in an unequivocal manner.2. As soon as possible, but within 14 days from the day following the notification referred to in paragraph 1, the consumer shall return the product, or hand it over to (an authorized representative of) the entrepreneur. This is not necessary if the entrepreneur has offered to collect the product himself. In any case, the consumer has complied with the return period if he returns the product before the cooling-off period has expired.3. The consumer shall return the product with all delivered accessories, if reasonably possible in the original state and packaging, and in accordance with the reasonable and clear instructions provided by the entrepreneur.4. The risk and the burden of proof for the correct and timely exercise of the right of withdrawal lies with the consumer.5. The consumer bears the direct costs of returning the product. If the entrepreneur has not reported that the consumer must bear these costs or if the entrepreneur indicates to bear the costs himself, the consumer does not have to bear the costs for return.6. If the consumer rescinds after having first expressly requested that the provision of the service or the supply of gas, water or electricity that have not been made ready for sale start in a limited volume or quantity during the cooling-off period, the consumer is the the entrepreneur owes an amount that is proportional to that part of the obligation that the entrepreneur has fulfilled at the moment of withdrawal, compared with the full fulfillment of the obligation.7. The consumer does not incur any costs for the execution of services or the supply of water, gas or electricity, which are not made ready for sale in a limited volume or quantity, or for the supply of district heating, if:
a.the entrepreneur the consumer the legally required information about the right of withdrawal, thereimbursement of costs in the event of withdrawal or failure to provide the standard form for withdrawal, or; 5b. the consumer has not expressly requested the commencement of the execution of the service or delivery of gas, water, electricity or district heating during the cooling-off period. 8. The consumer does not bear any costs for the full or partial delivery of digital content not supplied on a tangible medium if:1. prior to the delivery, it has not expressly agreed to the commencement ofthe fulfillment of the agreement before the end of the cooling-off period;2. he has not acknowledged losing his right of withdrawal when giving his consent; or3. the entrepreneur has failed to confirm this statement from the consumer.9. As contracts canceled by operation of law.the consumer uses his right of withdrawal, all additional
Article 9 – Obligations of the entrepreneur in case of withdrawal
1. If the entrepreneur makes the notification of withdrawal by the consumer electronically possible, he will send an acknowledgment of receipt immediately after receipt of this notification.2. The trader will reimburse all payments from the consumer, including any delivery costs charged by the trader for the returned product, without delay but within 14 days following the day on which the consumer notifies him of the withdrawal. Unless the entrepreneur offers to collect the product himself, he may wait to pay back until he has received the product or until the consumer demonstrates that he has returned the product, whichever comes first.3. The entrepreneur uses the same payment method that the consumer has used for reimbursement, unless the consumer agrees to another method. The reimbursement is free of charge for the consumer.4. If the consumer has opted for a more expensive method of delivery than the cheapest standard delivery, the entrepreneur does not have to reimburse the additional costs for the more expensive method.Article 10 – Exclusion of right of withdrawalThe entrepreneur can exclude the following products and services from the right of withdrawal, but only if the entrepreneur has clearly stated this in the offer, at least in time for the conclusion of the agreement:1. Products or services whose price is subject to fluctuations in the financial marketon which the entrepreneur has no influence and who can be within the withdrawal periodoccur2. Agreements concluded during a public auction. Become a public auctionmeans a sales method whereby products, digital content and / or services are offered by the entrepreneur to the consumer who is personally present or is given the opportunity to be personally present at the auction, under the supervision of an auctioneer, and where the successful bidder is obliged to to purchase products, digital content and / or services;3. Service contracts, after full execution of the service, but only if:1. the execution has begun with the express prior consent of the consumer; and2. the consumer has declared that he will lose his right of withdrawal as soon as the traderhas fully executed the agreement;3.Service agreements for the provision of accommodation, as in the agreement
Article 10 – Exclusion of right of withdrawal
The entrepreneur can exclude the following products and services from the right of withdrawal, but only if the entrepreneur has clearly stated this in the offer, at least in time for the conclusion of the agreement:1. Products or services whose price is subject to fluctuations in the financial marketon which the entrepreneur has no influence and who can be within the withdrawal periodoccur2. Agreements concluded during a public auction. Become a public auctionmeans a sales method whereby products, digital content and / or services are offered by the entrepreneur to the consumer who is personally present or is given the opportunity to be personally present at the auction, under the supervision of an auctioneer, and where the successful bidder is obliged to to purchase products, digital content and / or services;3. Service contracts, after full execution of the service, but only if:1. the execution has begun with the express prior consent of the consumer; and2. the consumer has declared that he will lose his right of withdrawal as soon as the traderhas fully executed the agreement;4. Service agreements for the provision of accommodation, as in the agreementa certain date or period of execution is provided and different than for residential purposes,freight transport, car rental services and catering;1. Agreements with regard to leisure activities, as in the agreement a specific dateor period of execution thereof is provided;2. Products manufactured according to specifications of the consumer, which are not prefabricated andwhich are manufactured on the basis of an individual choice or decision of the consumer, or thatclearly intended for a specific person;3. Products that spoil quickly or have a limited shelf life;4. Sealed products that are not suitable for reasons of health protection or hygieneto be returned and of which the seal has been broken after delivery;5. Products which by their nature are irrevocably mixed with other products after delivery;6. Alcoholic drinks of which the price was agreed at the conclusion of the contract,but the delivery of which can only take place after 30 days, and of which the actual valuedepends on fluctuations in the market on which the entrepreneur has no influence;7. Sealed audio, video recordings and computer software, the seal of which is afterdelivery is broken;612. Newspapers, magazines or magazines, with the exception of subscriptions to this; 13. The supply of digital content other than on a tangible medium, but only if:1. the execution has begun with the express prior consent of the consumer; and2. the consumer has stated that he thereby loses his right of withdrawal.
Article 11 – The price
1. During the period mentioned in the offer, the prices of the offered products and / or services will not be increased, except for price changes due to changes in VAT rates.2. Contrary to the previous paragraph, the entrepreneur can offer products or services whose prices are subject to fluctuations in the financial market and where the entrepreneur has no influence, with variable prices. This link to fluctuations and the fact that any mentioned prices are target prices are mentioned in the offer.3. Price increases within 3 months after the conclusion of the contract are only permitted if they are the result of statutory regulations or provisions.4. Price increases from 3 months after the conclusion of the contract are only permitted if the entrepreneur has stipulated this and: a. They are the result of statutory regulations or stipulations; orb. the consumer has the authority to terminate the agreement with effect from the day on which the price increase takes effect.5. The prices mentioned in the offer of products or services include VAT.
Article 12 – Compliance agreement and additional warranty
1. The entrepreneur warrants that the products and / or services comply with the agreement, the specifications stated in the offer, the reasonable requirements of soundness and / or usability and the legal rights existing on the date of the conclusion of the agreement. provisions and / or government regulations. If agreed, the entrepreneur also guarantees that the product is suitable for other than normal use.2. An additional guarantee provided by the entrepreneur, his supplier, manufacturer or importer never limits the legal rights and claims that the consumer can enforce against the entrepreneur under the contract if the entrepreneur has failed to fulfill his part of the contract. agreement.3. An additional guarantee is understood to mean every obligation of the entrepreneur, its supplier, importer or producer in which it assigns to the consumer certain rights or claims that go beyond what is legally required in the event that he has failed to fulfill his part of the contract. the agreement.
Article 13 – Delivery and execution
1. The trader will take the greatest possible care when receiving and implementing orders for products and when assessing applications for the provision of services.2. The place of delivery is the address that the consumer has made known to the entrepreneur.3. With due observance of what is stated in article 4 of these general terms and conditions, the entrepreneur will execute accepted orders expeditiously but no later than 30 days, unless another delivery period has been agreed. If the delivery is delayed, or if an order can not or only partially be executed, the consumer will receive notification no later than 30 days after he has placed the order. In that case, the consumer has the right to terminate the contract without penalty and the right to any compensation.4. After dissolution in accordance with the previous paragraph, the entrepreneur will immediately repay the amount that the consumer has paid.5. The risk of damage and / or loss of products rests with the trader up to the moment of delivery to the consumer or a pre-designated and made representative to the entrepreneur, unless explicitly agreed otherwise.
Article 14 – Duration transactions: duration, cancellation and extension
Cancellation:1. The consumer can enter into an agreement that has been concluded for an indefinite period and which extends to the regular delivery of products (including electricity) or services, at all times7cancellation with due observance of the agreed cancellation rules and a notice periodup to one month.2. The consumer can enter into a contract for a definite period and that extends to theregular delivery of products (including electricity) or services, to cancel at the end of the fixed term with due observance of the agreed cancellation rules and a notice period of no more than one month.3. The consumer may conclude the agreements referred to in the previous paragraphs:o – cancel at any time and not be limited to termination at a specific time or in onecertain period;o – cancel at least in the same way as they have entered into by him;o – always cancel with the same notice period as the entrepreneur has stipulated for himself.Extension:4. A contract that has been entered into for a definite period and that extends to the regular delivery of products (including electricity) or services may not be tacitly renewed or renewed for a fixed term.5. Notwithstanding the previous paragraph, a contract that has been entered into for a definite period and which extends to the regular delivery of daily news and weekly newspapers and magazines may be tacitly renewed for a fixed term of a maximum of three months, if the consumer has renewed this extension. agreement by the end of the extension can terminate with a notice period of no more than one month.6. A contract that has been entered into for a definite period and that extends to the regular delivery of products or services may only be tacitly renewed for an indefinite period if the consumer may cancel at any time with a notice period of no more than one month. The notice period is a maximum of three months in case the agreement extends to the regular, but less than once a month, delivery of daily, news and weekly newspapers and magazines.7. A contract of limited duration to the regular delivery of daily, news and weekly newspapers and magazines (trial or introductory subscription) is not tacitly continued and ends automatically after the trial or introductory period.Expensive:8. If an agreement has a duration of more than one year, the consumer may terminate the agreement at any time with a notice period of no more than one month, unless the reasonableness and fairness cancel before the end of the agreed term. to resist.
Article 15 – Payment
1. Unless otherwise stipulated in the agreement or additional conditions, the amounts due by the consumer must be paid within 14 days after the commencement date, or in the absence of a cooling-off period within 14 days after the close of the contract. agreement. In case of an agreement to provide a service, this period starts on the day after the consumer has received the confirmation of the agreement.2. When selling products to consumers, the consumer may never be obliged to pay in advance more than 50% in general terms and conditions. If payment in advance is stipulated, the consumer can not assert any rights regarding the execution of the order or service (s), before the stipulated advance payment has taken place.3. The consumer has the duty to report inaccuracies in provided or stated payment details to the entrepreneur without delay.4. If the consumer does not fulfill his payment obligation (s) on time, after he has been informed by the trader of the late payment and the trader the consumer has been granted a period of 14 days to still fulfill his payment obligations, after the payment has not been made within this 14-day period, the legal interest is due on the outstanding amount and the entrepreneur is entitled to charge the extrajudicial collection costs he has incurred. These collection costs amount to a maximum of: 15% over outstanding amounts up to € 2,500, =; 10% over the next € 2,500, = and 5% over the next € 5,000, = with a minimum of € 40, =. The entrepreneur may deviate from the aforementioned amounts and percentages for the benefit of the consumer.
Article 16 – Complaints procedure
1. The entrepreneur has a well-publicized complaints procedure and handles the complaint in accordance with this complaints procedure.82. Complaints about the execution of the agreement must be submitted fully and clearly described to the entrepreneur within a reasonable time after the consumer has discovered the defects.3. Complaints submitted to the entrepreneur will be answered within a period of 14 days from the date of receipt. If a complaint requires a foreseeable longer processing time, the entrepreneur will respond within the period of 14 days with a notice of receipt and an indication when the consumer can expect a more detailed answer.4. A complaint about a product, service or the service of the entrepreneur can also be submitted via a complaints form on the consumer page of the website of Stichting Webshop Keurmerk (http://keurmerk.info/Home/MisbruikOfKlacht) The complaint will then be both to the relevant entrepreneur as sent to Stichting Webshop Keurmerk.5. If the complaint can not be resolved by mutual agreement within a reasonable period or within 3 months after the submission of the complaint, a dispute arises that is subject to the dispute settlement rules.
Article 17 – Disputes
1. Only Dutch law applies to agreements between the entrepreneur and the consumer to which these general terms and conditions apply.2. Disputes between the consumer and the entrepreneur about the conclusion or performance of agreements with regard to products and services to be delivered or delivered by this entrepreneur, subject to the provisions below, can be submitted by both the consumer and the entrepreneur to the customer. Disputes Committee Webshop, PO Box 90600, 2509 LP in The Hague (www.sgc.nl).3. A dispute will only be dealt with by the Disputes Committee if the consumer has first submitted his complaint to the entrepreneur within a reasonable time.4. No later than twelve months after the dispute arises, the dispute must be submitted in writing to the Disputes Committee.5. If the consumer wants to submit a dispute to the Disputes Committee, the entrepreneur is bound by this choice. If the entrepreneur wishes to do so, the consumer will have to make a written statement within five weeks after a request made by the entrepreneur in writing, whether he wishes to do so or whether the dispute is to be dealt with by the competent court. If the entrepreneur does not hear the choice of the consumer within the period of five weeks, then the entrepreneur is entitled to submit the dispute to the competent court.6. The Disputes Committee will make a decision under the conditions as set out in the rules of the Disputes Committee (http://www.degeschillencommissie.nl/over-onss/decommittees / 2701 / webshop). The decisions of the Disputes Committee are made by way of binding advice.7. The Disputes Committee will not deal with a dispute or will discontinue the proceedings if the Entrepreneur is granted a moratorium, has been declared bankrupt or has effectively terminated his business activities, before a dispute has been dealt with by the Committee at the hearing and a final statement has been made.8. If, in addition to the Geschillencommissie Webshop, another disputed Disputes Committee affiliated to the Stichting Geschillencommissies voor Consumentenzaken (SGC) or the Klachteninstituut Financiële Dienstverlening (Kifid) is competent, for disputes concerning mainly the method of sale or provision of services at a distance the Geschillencommissie Stichting Webshop Keurmerk preferably authorized. For all other disputes the other recognized disputes committee affiliated with SGC or Kifid.
Article 18 – Branch guarantee
1. Stichting Webshop Keurmerk guarantees compliance with the binding recommendations of the Disputes Committee Foundation Webshop Keurmerk by its members, unless the member decides to submit the binding opinion to the court for review within two months after sending it. This guarantee revives if the binding advice has been maintained after review by the court and the judgment that shows this has become final. Up to an amount of € 10,000 per binding advice, this amount is paid to the consumer by Stichting Webshop Keurmerk. For amounts greater than € 10,000, – per binding advice, € 10,000 will be paid out. For the multiple, Stichting Webshop Keurmerk has a best efforts obligation to ensure that the member complies with the binding advice.2. For the application of this guarantee is required that the consumer makes a written appeal to Stichting Webshop Keurmerk and that he transfers his claim on the entrepreneur to Stichting9Webshop Keurmerk. If the claim against the entrepreneur amounts to more than € 10,000, the consumer is offered to transfer his claim in so far as it exceeds the amount of € 10,000, to the Stichting Webshop Keurmerk, after which this organization pays the payment in its own name and costs. in court will ask for satisfaction to the consumer.
Article 19 – Additional or different provisions
Additional provisions or deviating from these terms and conditions may not be to the detriment of the consumer and must be recorded in writing or in such a way that they can be stored by the consumer in an accessible manner on a durable medium.
Article 20 – Modification of the general terms and conditions of Stichting Webshop Keurmerk
1. Stichting Webshop Keurmerk will not change these general conditions than in consultation with the Consumers’ Association.2. Amendments to these terms and conditions shall only take effect after they have been published in the appropriate manner, on the understanding that in case of applicable changes during the term of an offer the most favorable provision for the consumer will prevail.Address Webshop Foundation Trustmark: Willemsparkweg 193, 1071 HA Amsterdam 10Annex I: Model form for withdrawalModel withdrawal form (only complete and return this form if you wish to withdraw from the contract)• – To: [name of entrepreneur][entrepreneur’s geographical address] [entrepreneur’s fax number, if available] [e-mail address or e-mail address of entrepreneur]• – I / We * share / share * hereby inform you that I / we * our agreement concerning the sale of the following products: [product designation] * the delivery of the following digital content: [indication digital content] * the transaction of the following service: [service designation] *, revoke / revoke *• – Ordered on * / received on * [date of ordering with services or receipt of products]• – [Consumer name (s)]• – [Consumer address (s)]• – [Signature of consumer (s)] (only when this form is submitted on paper)* Delete what is not applicable or fill in what is applicable.