Please complete and return this form only if you wish to withdraw from your order placed on our website

To the attention of Digital Assets Management 10 Avenue des Alouettes, 33320 Eysines

I hereby notify you of my withdrawal from the contract for the sale of the following goods:

Ordered on ............................................

Order number: ................................................................................

Customer name: ..........................................................................

Customer address: ..........................................................................

Signature of the client (only if this form is notified on paper) :

Date: ..........................................................................