Business terms

The online store at http://www.mobileorigin.com is operated by the commercial company Ingredi Europa s.r.o., with its registered office at Krajánkova 3176/2, 141 00 Prague, Company ID: 28544668, registered in the Commercial Register maintained by the Municipal Court in Prague, Section C, Entry 149265, VAT ID: CZ28544668. You can contact us via our email or phone.

Once you submit your order through the online store, a contract is concluded. We will confirm the acceptance of your order and the conclusion of the contract via email.

Make the payment within 3 days of concluding the contract or later, depending on the selected payment method.

As a consumer, you may withdraw from the concluded contract at any time up to 14 days from the date of receiving the goods. Details of contracts from which withdrawal is not possible can be found in the full text of the terms and conditions. We may withdraw from the concluded contract at any time until the moment you receive the goods from us. After withdrawing from the contract, you will return the goods to us, including any gifts or bonuses we may have provided, at your own expense, within 30 days of withdrawal. We will refund your money within 10 days of receiving the withdrawal notice, but not before you return the goods to us or prove that the goods have been sent to us.

If you order tangible goods or digital goods on a physical medium from our online store, this results in the conclusion of a purchase contract.

You become the owner of the goods upon receiving them, but not before you have fully paid the total price. If damaged goods are delivered to you as a consumer, inform us immediately. If you discover the damage upon receiving the goods, also notify the carrier of the damage. If damaged goods are delivered to you as a business, address the damage with the carrier.

If you are a consumer, you have the right to claim defects that appear on the goods within 2 years of receiving them. As a business, you may claim defects that existed on the goods at the time the risk of damage passed to you within 6 months, or in the case of hidden defects, within 2 years of receiving the goods. Details on how to claim goods and what you can request in case of a claim can be found further in the terms and conditions.

General Provisions

Scope of the Terms and Conditions. These terms and conditions govern the conclusion of contracts between us as the merchant and you as the customer through the online store, as well as our and your rights and obligations arising from the contracts. The terms and conditions also include mandatory information. Information about the processing of personal data can be found in a separate document on our website. The terms and conditions take effect on February 5, 2025.
Definitions Used. In our terms and conditions, we use the following abbreviations:
1. "We" refers to the merchant, i.e., the commercial company Ingredi Europa s.r.o., with its registered office at Krajánkova 3176/2, 141 00 Prague, Company ID: 28544668, registered in the Commercial Register maintained by the Municipal Court in Prague, Section C, Entry 149265, VAT ID: CZ28544668.
2. "You" refers to the customer, i.e., the other contracting party distinct from us, which may be one of the following entities:
  1. A consumer, meaning a person not acting within the scope of their business activity or independent profession,
  2. A business, meaning a person or legal entity acting within the scope of their business activity or independent profession.
3. "Online store" refers to our web interface located at the web address http://www.mobileorigin.com, where you can view our offer and order goods from our range.
4. "Email" refers to electronic mail through which you can contact us at the email address available on our online store’s website.
5. "Phone" refers to the means by which you can contact us at the phone number available on our online store’s website.
6. "Contracts" refer to purchase contracts.
Relationship of the Terms and Conditions to the Contract. The terms and conditions form an integral part of all contracts. Any deviating provisions in the contract take precedence over the wording of the terms and conditions.
Relationship of the Contract and Terms and Conditions to Legal Regulations. Rights and obligations not regulated by the terms and conditions or the contract are governed by the legal regulations of the Czech Republic, in particular Act No. 89/2012 Coll., the Civil Code, and Act No. 634/1992 Coll., on Consumer Protection, in accordance with the legal regulations of the European Union, particularly Directive 2011/83/EU on Consumer Rights and Directive 2000/31/EC on Electronic Commerce. In case of a conflict between the terms and conditions or the contract and a legal regulation, unless it concerns a matter that can be contractually modified, the legal regulation takes precedence.
Severability of Provisions. If any provision of the terms and conditions or contractual agreements becomes invalid, ineffective, or disregarded, this does not affect the validity and effectiveness of the remaining provisions of the terms and conditions and contractual agreements.
Relationships with an International Element. Legal relations between us and you, in the presence of an international element, are governed by Czech law, and Czech courts are competent to resolve any disputes. The United Nations Convention on Contracts for the International Sale of Goods (Vienna Convention) does not apply.
Methods of Complaint Resolution. Any complaints and disputes between you and us can be resolved:
1. Out of court in proceedings conducted by the Czech Trade Inspection Authority (adr.coi.cz) or through the online dispute resolution platform established by the European Commission (ec.europa.eu/consumers/odr),
2. Via email to our email address,
3. In person at any of our establishments,
4. By phone at our phone number.
Supervisory Authorities. Our activities are subject to inspection and supervision by state authorities of the Czech Republic, to which you may address your suggestions in accordance with the legal regulations governing their scope and powers. The supervisory authorities include, in particular:
1. The Czech Trade Inspection Authority,
2. Trade Licensing Offices,
3. The Office for Personal Data Protection.

Ordering Goods and Concluding Contracts

Ordering Goods. You can order goods in our online store by accepting our offer to conclude a contract, which is represented by the display of goods in the online store, through:
1. The online store.
  
  Acceptance of our offer with any amendment or deviation is not possible and is considered a counteroffer from your side.
Ordering Goods via the Internet. You order goods through the online store by selecting the offered goods in the desired quantity, quality, and version, adding them to the virtual cart, filling in the required details, choosing the delivery and payment method, and submitting your order using the “Order with Payment Obligation” button, thereby concluding the contract. Before submitting the order, you will have the opportunity to review and, if necessary, amend the entered details.
Confirmation of Order Acceptance. We will confirm the successful acceptance of your order and the conclusion of the contract by sending an email to your email address, which will include:
1. Confirmation of the contract conclusion and its contents,
2. Our terms and conditions, which include mandatory information.
  
  In case of incomplete or incorrect order details, we will ask you to complete them or inform you of the impossibility of concluding the contract.
Language and Storage of the Contract. Contracts are concluded in Czech and also in the English language. We store concluded contracts, and you can access your contracts through the online store.

Concluded Contracts and Their Contents

Amendment and Cancellation of the Contract. Concluded contracts cannot be unilaterally amended or canceled; this can only be done based on mutual agreement or if stipulated by legal regulations or the terms and conditions.
Contents of the Purchase Contract. Based on the concluded purchase contract, we are obliged to deliver the ordered tangible goods to you in the agreed manner and provide any agreed services, while you are obliged to accept the goods and pay us the total price, consisting of the price of the ordered goods, payment costs, delivery costs, and costs of any additional ordered services.
Intellectual Property Protection. If we supply you with goods protected by intellectual property rights (particularly copyrights, trademarks, industrial designs, patents, and utility models) based on the contract, the contract does not include a license to exercise intellectual property rights. Goods protected by copyright may not be used by you as an individual for purposes other than personal use or by a legal entity for purposes other than internal use; in particular, you are not authorized to reproduce, resell, rent, or otherwise make the goods available to third parties.
Discounts and Promotions. For discount or other marketing promotions, unless otherwise specified, individual discounts and benefits provided cannot be combined.
Gifts and Bonuses. If you are provided with gifts or other bonuses under the contract, this is based on a gift contract, and therefore we are not liable for their defects. The existence of the gift contract depends on the existence of the main contract, and the gift contract is concluded with a condition of termination in case the main contract ceases to exist.
Discount Coupons and Gift Vouchers. Discount coupons and gift vouchers can be redeemed under the agreed terms or conditions stated on the coupon or voucher. Unless otherwise agreed, they can only be redeemed with us, and their validity is limited—for discount coupons until revoked or the end of the discount promotion, and for gift vouchers for one year from their issuance.

Payment Terms

Payment Methods. The total price can be paid using methods listed on the relevant page of our online store.
Payment Deadline. You are obliged to pay the total price either before the delivery of the goods, upon receipt of the goods, or later, depending on the agreed payment method. If the total price is to be paid before delivery, you must pay it within 3 days of concluding the contract. If the total price is paid through a payment service provider, it is considered paid upon crediting the amount to our account with the payment service provider.
Payment via Credit. If payment of the total price is arranged through credit or another financial product based on a contract with a financial service provider, this relationship is also governed by the contract and terms of the financial service provider.
Electronic Issuance of Tax Documents. You agree that we will issue and send you an invoice (tax document) electronically to the email address provided during the order.

Delivery Terms

Delivery Methods. The delivery methods available to you can be found on the relevant page of our online store.
Delivery Restrictions. Delivery of goods with us is not subject to any geographical restrictions.
Acquisition of Ownership. You become the owner of the goods delivered to you upon their receipt, but not before you have fully paid the total price.
Delivery Timeframe. The agreed delivery timeframe begins upon the conclusion of the contract. If you are a consumer and no delivery timeframe is agreed, we will deliver the goods to you without undue delay, no later than 30 days from the date of concluding the contract. If the total price is to be paid before delivery, the delivery timeframe begins after the total price is paid. The goods will be delivered to the designated location within this timeframe. If you are not a consumer and the goods are to be delivered to the designated location via a carrier, the goods will be handed over to the carrier within this timeframe.
Receipt of Goods. You are obliged to receive the goods at the agreed time and place depending on the delivery method. If the goods are to be delivered via a carrier, you must receive them upon delivery to the designated location. If you fail to receive the goods, we gain the right to withdraw from the contract, the right to payment of costs associated with the delivery of the goods if not paid prior to delivery, and the right to a storage fee for the period the goods are stored, ending when you receive the goods, withdraw from the contract, or we withdraw from the contract. The storage fee is 10 CZK per day, but its total amount must not exceed the price of the stored goods. If we subsequently deliver the goods to you again after you fail to receive them, we are entitled to reimbursement of the costs associated with the repeated delivery.
Identity Verification upon Receipt. If the goods were paid for before delivery, we are entitled to condition the handover of the goods on verifying the identity of the receiving person based on an identification document.
Damage to Goods During Transport to a Consumer. If you are a consumer, the risk of damage to the goods passes to you upon receipt. If the goods are delivered to you damaged, you must inform us of the damage immediately, preferably:
1. Via email to our email address.
  
  If you notice damage to the shipment upon receipt, you must inform not only us but also the carrier during receipt. You may request the carrier to unpack the damaged shipment before receipt, and if you find the goods damaged, you are not obliged to accept them from the carrier.
Damage to Goods During Transport to a Business. If you are not a consumer and the goods are to be delivered via a carrier, the risk of damage to the goods passes to you upon handover to the carrier. If damage to the goods occurs after the risk of damage has passed, we are not liable for it, and the damage does not affect your obligation to pay the total price and receive the goods. If the goods are delivered to you damaged, you must immediately claim the damage with the carrier.
Packaging of Goods. Unless otherwise agreed, the goods will be packaged in a manner suitable for their preservation and protection.

Right to Withdraw from the Contract

General Information on Withdrawal. By withdrawing from a concluded contract, the contract is canceled from the outset, and the parties are obliged to return everything provided under the canceled contract. Withdrawal from the contract also cancels any dependent gift contract. The right to withdraw from the contract can be exercised under the conditions set out in the terms and conditions or as provided by legal regulations.
Our Right to Withdraw from the Contract. We have the right to withdraw from the concluded contract at any time from the date of its conclusion until the moment you receive the goods from us, for the following reasons:
1. Exhaustion of stock of the ordered goods,
2. Failure to receive the goods upon delivery,
3. Abuse of the ordering system of our online store,
4. Provision of incorrect data when ordering the goods,
5. Ordering goods at a price significantly lower than the usual price if the goods were offered at that price due to an error or mistake in our online store,
6. Other reasons worthy of special consideration.
Consumer’s Statutory Right to Withdraw from the Contract. If you are a consumer, you have the right to withdraw from the concluded purchase contract within 14 days from the date of:
1. Receiving the goods,
2. Receiving the last item of goods if you order multiple items within one order that are delivered separately,
3. Receiving the last item or part of a delivery of goods consisting of multiple items or parts,
4. Receiving the first delivery of goods if the contract stipulates regular delivery of goods for an agreed period,
5. Concluding the contract, if it concerns another type of contract.
Impossibility of Withdrawal from the Contract. You do not have the right to withdraw from contracts:
1. For the supply of goods manufactured according to your specifications or tailored to your needs,
2. For the supply of goods in sealed packaging that, for health or hygiene reasons, cannot be returned once the packaging has been opened by you,
3. For the supply of goods that are perishable or have a short shelf life, as well as goods that, due to their nature, have been irreversibly mixed with other goods after delivery,
4. For the provision of services if they have been fully provided,
5. Others, if so stipulated by legal regulations.
Method of Withdrawal from the Contract. If you have the right to withdraw from the contract and wish to do so, you may do so by a unilateral legal act delivered to us, preferably:
1. By completing the sample withdrawal form attached to the terms and conditions and sending it:
  1. Via email to our email address;
2. In person at any of our establishments.
Compliance with the Deadline. If you are a consumer, to meet the withdrawal deadline, it is sufficient to send the withdrawal notice to us on the last day of the withdrawal period.
Return of Goods After Withdrawal. If you withdraw from the contract, you are obliged to return the goods to us at your own expense, preferably simultaneously with the withdrawal, no later than 30 days from the delivery of the withdrawal notice, preferably:
1. By sending the goods to the address of any of our establishments,
2. By handing the goods over to a carrier who, based on prior agreement, will pick them up at an agreed place and time.
  
  You must return the goods to us undamaged, unsoiled, unworn, and showing no signs of use, including all accessories and documentation, if possible in the original packaging. You are also obliged to return any gifts and bonuses received under the canceled contract.
Refund After Withdrawal. If you, as a consumer, withdraw from the contract, we will refund the paid funds to you within 10 days of receiving the withdrawal notice, but not before you return the goods to us or prove that the goods have been sent to us. We will refund the paid delivery costs only up to the amount corresponding to the cheapest comparable delivery method we offer. If the value of the returned goods decreases due to handling beyond what is necessary to ascertain their nature, properties, and functionality, the refunded amount will be reduced by the amount by which the value of the goods has decreased. We will refund the funds to you in the same manner as we received them from you, or by another method agreed upon, provided it does not incur additional costs for you.

Consumer Claims for Defective Goods

Scope. This section of the terms and conditions applies to you only if you are a consumer and governs our liability for defective goods.
Claim Period. You can claim a defect that appears on the goods within 2 years, or for used goods within 1 year, from the date of receipt. For goods with digital features, you can claim a defect in the digital content or digital content service, which are to be provided continuously for a certain period, if it appears or occurs within 2 years of receiving the goods. If the digital content or service is to be provided for a longer period, you can claim defects that occur or appear during that longer period.
Our Liability for Defects. We are liable to you that the goods are free of defects upon receipt. In particular, we are liable that the item:
1. Matches the agreed description, type, and quantity, as well as quality, functionality, compatibility, interoperability, and other agreed characteristics,
2. Is suitable for the purpose you require, if we have agreed to it,
3. Is delivered with the agreed accessories and instructions for use, including assembly or installation instructions.
Further, we are liable to you that, in addition to the agreed characteristics, the goods meet the following requirements; this does not apply if we informed you before concluding the contract that some characteristics of the goods differ and you agreed to it:
1. Suitable for the purpose for which goods of this type are usually used, considering third-party rights, legal regulations, technical standards, or industry codes of conduct if there are no technical standards,
2. In quantity, quality, and other characteristics, including durability, functionality, compatibility, and safety, corresponds to the usual characteristics of goods of the same type that you can reasonably expect, also considering public statements made by us or another person in the same contractual chain, particularly in advertising or labeling; we are not bound by a public statement if we were unaware of it, it was amended at least comparably by the time of concluding the contract, or it could not have influenced the purchase decision,
3. Is delivered with accessories, including packaging, assembly instructions, and other instructions for use that you can reasonably expect,
4. Matches the quality or design of the sample or model we provided to you before concluding the contract.
Liability for Updates for Goods with Digital Features. For goods with digital features, we are liable for ensuring the provision of agreed updates to the digital content or digital content service. In addition to the agreed updates, we will also provide updates, including notifications of their availability, necessary to ensure the goods retain the agreed characteristics and requirements for these goods, for:
1. Two years if the digital content or service is to be provided continuously for a certain period under the contract, and if a period longer than two years is agreed, for that entire period,
2. The period you can reasonably expect if the digital content or service is to be provided one-time under the contract.
Limitation of Liability. We are not liable to you:
1. For wear and tear of the goods corresponding to the extent of their prior use,
2. For used goods, for a defect corresponding to the extent of use or wear the goods had upon receipt,
3. For consumable goods with a specified minimum durability period or perishable goods with a specified usability period, for the unusability of the goods after the specified period expires,
4. If you caused the defect yourself,
5. For goods with digital features, for failure to provide necessary updates if you were informed before concluding the contract that updates would not be provided and you agreed to it,
6. For goods with digital features, for defects arising from failure to perform a necessary update.
Timeframe for Exercising Rights. You are obliged to inspect the goods as soon as possible and verify their characteristics and quantity. You must exercise your rights arising from liability for defective goods with us without undue delay, as soon as you can detect the defects, within the claim period. If a defect appears within one year of receipt, it is presumed that the goods were defective upon receipt, unless the nature of the goods or defect precludes this.
Right to Defect Removal. If the goods have a defect, you have the right to its free removal, at your choice, either by delivery of new defect-free goods or repair of the goods. You do not have the right to choose the method of defect removal if the method you choose is impossible or unreasonably costly compared to the alternative method.
Right to a Reasonable Discount or Withdrawal from the Contract. If we refuse to remove the defect or fail to remove it, or if the defect reoccurs, or the defect constitutes a material breach of the contract, or it is evident from our statement or circumstances that the defect will not be removed within a reasonable time or without significant inconvenience to you, you may request a reasonable discount or withdraw from the contract. You do not have the right to withdraw from the contract if the defect is insignificant.
Method of Claim. If you wish to exercise your rights arising from liability for defects, you can do so preferably:
1. By sending the goods to the address of any of our establishments,
2. By handing the goods over to a carrier who, based on prior agreement, will pick them up at an agreed place and time,
3. If another person designated to handle liability for defects is specified in the warranty certificate, other document, on the goods’ packaging, or in our online store, with that person.
Claim Requirements. The goods must be submitted to us in a condition that allows assessment of the claim’s validity, particularly not excessively soiled. When making a claim, you must:
1. Prove that the goods were purchased from us,
2. Specify the defect you are claiming and how you request the claim to be resolved. The requested method of resolving the claim cannot be changed later without our consent.
Claim Resolution. Your claim will be resolved within a reasonable time, no later than 30 days from the date of filing the claim. You will be notified of the claim resolution within this period, and the goods will be returned to you in the same manner as they were submitted to us. If the claim is not resolved in time, you have the right to withdraw from the contract or request a reasonable discount from the price. If your claim is accepted, the period for raising defects and the presumption of defect existence upon receipt is extended by the time you could not use the goods.
Reimbursement of Claim Costs. In the case of a claim, you are entitled to reimbursement of necessary costs reasonably incurred in exercising your rights arising from liability for defective goods. If the claim is rejected, we are entitled to reimbursement of necessary costs incurred in returning your goods.
Claim Confirmation. When exercising your rights arising from liability for defective goods, we will issue you a written confirmation stating when you exercised the right, the content of the claim, and the requested method of resolution, as well as confirmation of the date and method of claim resolution, including confirmation of any repair and its duration, or a written justification for rejecting the claim.
Extended Quality Warranty. Beyond your statutory rights, you may be provided with an extended quality warranty for the goods. This arises from a statement by the warranty provider, which may also be made through advertising, that you will be satisfied beyond your statutory rights for defective performance if the goods do not have the characteristics stated in the warranty statement. Rights arising from the extended quality warranty and the conditions for exercising them are governed by the warranty provider’s statement. If the warranty provider guarantees that the goods will retain their functions and performance under normal use for a certain period, or if a warranty period or usability period is stated on the goods’ packaging, you have at least the right to delivery of new defect-free goods or their repair from the warranty provider.

Business Claims for Defective Goods

Scope. This section of the terms and conditions applies to you only if you are not a consumer and governs our liability for defective goods.
Our Liability for Defects. We will deliver the goods to you in the agreed quantity, quality, and design. If quality and design are not agreed, we will deliver the goods in a quality and design suitable for the purpose evident from the contract; otherwise, for the usual purpose. If the quantity is only approximate, we will determine the exact quantity. If the goods have a defect at the time the risk of damage passes to you, we are liable for it. This does not apply if the defect could have been detected with ordinary care at the time of concluding the contract.
Limitation of Liability. We are not liable to you:
1. For goods sold at a lower price, for a defect for which the lower price was agreed,
2. For wear and tear of the goods caused by their normal use,
3. For used goods, for a defect corresponding to the extent of use or wear the goods had upon receipt,
4. For defects in goods, particularly consumable and perishable goods, if this follows from their nature,
5. For defects in goods if you knew about them before receiving the goods,
6. For defects in goods if you caused them yourself.
Timeframe for Exercising Rights. You are obliged to inspect the goods as soon as possible and verify their characteristics and quantity. You must exercise your rights arising from liability for defective goods with us without undue delay, as soon as you can detect the defects. The right must be exercised no later than 6 months, or for hidden defects within 2 years, from the date we deliver the goods to you. Otherwise, your right arising from liability for defective goods expires and will not be granted.
Your Rights in Case of a Material Breach of Contract. If the defect constitutes a material breach of the contract, you have the right to:
1. Removal of the defect by delivery of new defect-free goods or delivery of missing goods,
2. Removal of the defect by repair of the goods,
3. A reasonable discount from the purchase price, or
4. Withdraw from the contract.

A material breach of the contract is considered the delivery of goods with a defect that we must have known about at the time of concluding the contract, such that if you had foreseen it, you would not have concluded the contract with us; in other cases, the breach of the contract is considered non-material. If you do not inform us of your chosen right, you have the rights as in the case of a non-material breach of the contract.

Your Rights in Case of a Non-Material Breach of Contract. If the defect constitutes a non-material breach of the contract, you have the right to:
1. Removal of the defect,
2. A reasonable discount from the purchase price.
  
  If you do not inform us of your chosen right, we may remove the defect by repairing the goods, delivering new goods, or delivering what we failed to deliver. You cannot later change the chosen right without our consent.
Inability to Request Withdrawal or Delivery of New Goods. If you cannot return the goods in the condition in which you received them, you cannot withdraw from the contract or request delivery of new goods. This does not apply if:
1. The change in condition resulted from an inspection to detect a defect in the goods,
2. You used the goods before discovering the defect,
3. You did not cause the inability to return the goods in an unchanged condition by your action or omission,
4. You sold the goods before discovering the defect, consumed them, or altered them during normal use; if this happened only partially, you will return what you can still return and provide compensation for the remainder up to the amount you benefited from using the goods.
Method of Claim. If you wish to exercise your rights arising from liability for defects, you can do so:
1. By sending the goods to the address of any of our establishments,
2. By handing the goods over to a carrier who, based on prior agreement, will pick them up at an agreed place and time,
3. If another person designated to handle liability for defects is specified in the warranty certificate, other document, on the goods’ packaging, or in our online store, with that person.
Claim Requirements. The goods must be submitted to us in a condition that allows assessment of the claim’s validity, particularly not excessively soiled. When making a claim, you must:
1. Prove that the goods were purchased from us,
2. Specify the defect you are claiming and how you request the claim to be resolved. The requested method of resolving the claim cannot be changed later without our consent.
Claim Resolution. Your claim will be resolved without undue delay, no later than 45 days. The goods will be returned to you in the same manner as they were submitted to us. If your claim is accepted, the period for exercising your rights arising from liability for defects is extended by the time it took us to resolve your claim.
Reimbursement of Claim Costs. If your claim is accepted, you are entitled to reimbursement of necessary costs reasonably incurred in exercising your rights arising from liability for defective goods. If the claim is rejected, we are entitled to reimbursement of necessary costs incurred in returning your goods.
Extended Quality Warranty. Beyond your statutory rights, you may be provided with an extended quality warranty for the goods. This arises from a statement by the warranty provider, which may also be made through advertising, that you will be satisfied beyond your statutory rights for defective performance if the goods do not have the characteristics stated in the warranty statement. Rights arising from the extended quality warranty and the conditions for exercising them are governed by the warranty provider’s statement. If the warranty provider guarantees that the goods will retain their functions and performance under normal use for a certain period, or if a warranty period or usability period is stated on the goods’ packaging, you have at least the right to delivery of new defect-free goods or their repair from the warranty provider.

Additional Provisions

Take-Back. In accordance with legal regulations governing take-back, you have the option, when purchasing certain types of goods, to return the same quantity of goods of a similar type and use free of charge at the point of sale.

Attachments

Withdrawal from the Contract

Recipient:
Ingredi Europa s.r.o., Krajánkova 3176/2, 141 00 Prague, Company ID: 28544668, VAT ID: CZ28544668

I/we* hereby declare that I/we* withdraw from the contract for the purchase of these goods* / the provision of these services*:

Order number (optional, for faster processing of the request):

Date of order* / Date of receipt*:

Name and surname of the consumer(s):

Address of the consumer(s):

Date:

Signature of the consumer(s) (only if this form is submitted in paper form):

(*) Strike out or complete the inapplicable information.