GENERAL TERMS AND CONDITIONS OF SALES
Welcome to the www.sanareva.co.uk website (hereinafter referred to as the “Site”), published by the company HOLDING OMNIPHAR’ 07 (hereinafter referred to as “SANAREVA” or the “Seller”). A simplified joint stock company, listed in the Toulouse Trade and Companies Register under number 502 801 764, whose head office is located at 4 Impasse Bel Souleil 31850 Montrabé, FRANCE.
The current General Terms and Conditions of Sale (hereinafter referred to as the "Terms of Sales") are concluded between SANAREVA, on the one hand, and the consumer, a non-professional individual (hereinafter referred to as the "Customer") with intention of making a purchase on the Site, on the other hand.
The present Terms of Sales exclusively governs the contractual relationship and conditions between SANAREVA and any person consulting the Site or intending to use the services provided by the Site or to purchase products (hereinafter referred to as the "Product(s)") offered on this Site.
2.1 Product features
The Customer may, prior to an order, take note of the essential characteristics of the Products he/she wishes to order by consulting the pre-contractual information provided by SANAREVA before ordering.
The product images are provided for illustration purposes only. SANAREVA will make every effort to ensure regular updates of the Product illustrations available for sale on the Site.
2.2 Stock availability
Products are offered and delivered within the limits of available stocks. The SANAREVA Product catalogue is subject to constant change.
In the event of a Product ordered that is out of stock, the price of the missing product ordered by the Customer is automatically credited to his/her Sanareva loyalty fund (hereinafter referred to as the "Sanareva Savings") or will be refunded to the Customer's bank account if he/she so desires. SANAREVA will refund the Product within thirty (30) days.
Other than the refund regarding the price of the unavailable Product, SANAREVA is not liable for any further compensation.
In the case of an order placed using Sanareva Savings (see Article 7 "Sanareva Savings" below) for a product that is out of stock, refunds can only be re-issued as store credit and under no circumstances be refunded to the Customer's personal bank account.
The selling price of the Products are those in force on the day the order is placed.
In the case of a promotional price, SANAREVA commits to applying this price to all orders placed during the advertising period of the promotion.
SANAREVA reserves the right to modify prices at any time.
The selling price of the Products do not include the delivery fees, which are invoiced additionally as stipulated in Article 6 of the present Terms of Sales.
Prices are inclusive of Value-added tax (VAT) at the applicable rate valid at the time the order is accepted. Any change in the applicable VAT rate will be reflected on the price of Products sold on the Site.
In certain cases, the Customer may be subject to custom duties in addition to the price of the order, for which the Customer is fully responsible to pay directly to the requesting administration.
Any order implies complete acceptance of the Terms of Sales.
By validating his/her order by clicking on "Accept Terms & Conditions and order" and "Confirm my payment", the Customer is considered to have knowingly accepted the content and conditions of the order and more particularly the fact that the order implies an obligation to pay. SANAREVA will then proceed to collect the full amount of the price corresponding to the order.
Once the order placed by the Customer has been confirmed, the order is considered final, unless the Customer exercises his right of withdrawal under the conditions of article 8 "Right of withdrawal" of the present Terms of Sales.
SANAREVA confirms the order by sending an email to the Customer. A second email is sent to the Customer upon total or partial dispatch of the order.
SANAREVA reserves the right to cancel any order belonging to a Client with whom there is a dispute concerning the payment of a previous order or for whom SANAREVA suspects fraudulent behaviour on the part of the Client. The information given by the Customer, when taking an order and/or creating a Customer account, is the customer's responsibility and is binding on the latter: in the event of an error in the wording of the Customer's or recipient's contact details, SANAREVA cannot be held responsible for any delay or impossibility to deliver the Product(s) ordered.
SANAREVA will be able to monitor the orders placed via its customer service. In order to protect itself against any fraudulent practice, the customer service department may be led to ask the Customer for all the supporting documents necessary for the validation of an order which seems suspicious (photocopy of identity card, proof of address etc.).
The purchase of Products is exclusively reserved for personal use and consumption.
The following clause applies to the sale of products from the following brands: La Roche Posay, Vichy, Skinceuticals and Roger & Gallet. The Customer may not purchase more than six (6) units of the same item per day, per customer or per order. Any order containing more than the allowed number of units will be refused and the supplier will be notified.
The sale of the entire Pierre Fabre Dermo Cosmetique range (Avène, A-derma, Ducray, Galénic, Klorane, Elancyl and René Furterer) is limited to the European Economic Area. Any sale made outside this area will immediately be refunded.
European Economic Area: Austria, Belgium, Bulgaria, Cyprus (Greek part), Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, United Kingdom, Iceland, Liechtenstein, Norway.
Pierre Fabre Dermo Cosmetique (Avène, A-derma, Ducray, Galénic, Klorane, Elancyl and René Furterer) limits the sale of their products to 6 identical items sold to a single user in a period of 15 consecutive days. We are required to inform Pierre Fabre of any order requesting more than the permitted quantity.
5.1 Payment methods
The Client guarantees SANAREVA that he/she is the holder of the payment method used to place an order on the Site. If this is not the case, the Customer certifies that he/she has the authorisation by the owner to use it to place the order.
SANAREVA offers to the Customers the following payment options:
- Credit/Debit card: Visa card, MasterCard, American Express, Maestro
- Sanareva Savings Credit: issued by SANAREVA to be used exclusively on the Site and by the beneficiary Customer only, valid for one year from the date of issue.
5.2 Terms of payment
Payment is made exclusively through the payment methods made available to the Client by SANAREVA.
Payment via the previously indicated payment methods, can be done online, through our website.
All prices are indicated in British pounds, the orders should be paid in the same currency, and it includes all taxes and contributions. The Customer shall bear any possible additional costs in terms of customs duties as well as any possible additional costs invoiced by his bank or financial establishment in relation to the order.
Once the payment has been validated, the order will be processed by SANAREVA. In the event of total or partial non-payment or fraud or attempted fraud, SANAREVA will legally proceed with the cancellation of the contested order.
SANAREVA guarantees the implementation of security measures to ensure the security of payments on its Site. For this purpose, SANAREVA offers to its Customers a payment interface deployed by HiPay and a payment verification system made by bank cards, named "3D Secure".
To do this, the Seller offers the Customers a payment interface deployed by HiPay and a payment verification system made by bank cards, named "3D Secure".
SANAREVA reserves the right to ask the Client for any additional documentary evidence in order to complete the order.
In general, the delivery by air of Aerosol Products cannot be ensured in connection with the security measures imposed by the carriers.
6.1 Delivery method
SANAREVA offers its Customers the following delivery methods:
- home delivery with DPD
- home delivery with Hermes (or at a relay point)
For more information about delivery solutions and rates, SANAREVA invites its Customers to visit the following page: Our delivery solution.
6.2 Claims regarding the courier services
SANAREVA advises the Customer to check at the time of receipt, with the carrier, or at the collection point, that his/her order has not been damaged
If the package is likely to have been opened or if it bears obvious signs of deterioration, the Client has a period of 10 days from the date of delivery, to make any necessary complaints to the carrier.
The Customer may also submit a complaint to SANAREVA under the conditions indicated in article 15 "Complaints" of the present Terms of Sale.
6.3 Delivery times
Products are dispatched within 48 working hours from the day on which we accept your order. In the United-Kingdom and Republic of Ireland, the carrier delivers the order on average within 3 to 5 working days following their reception of the parcel.
For more information about delivery times observed, SANAREVA invites its Customers to visit the following page: Our delivery solution
The delivery delay starts from the moment the order is dispatched by SANAREVA. The Client is informed that these observed delivery times are provided for information purposes only, and that they may vary according to circumstances. SANAREVA shall not be held liable in the event of longer delivery times, as long as the legal delivery period of 30 days is respected.
If the legal deadline of 30 days is exceeded, the Customer has the right and possibility of cancelling the order and requesting a refund, if, after sending a formal notice by registered mail or by email to SANAREVA's Customer Service department asking them to make the delivery within a reasonable extension of time, SANAREVA has failed to do so within this new deadline. Refunds will be made at the Customer's discretion, in the form of a credit on the Customer's Sanareva Savings or a refund, and will be made within 14 days of the Customer's request for a refund at the latest.
In case of delay or cancellation of the order due to the occurrence of a case of force majeure, SANAREVA cannot be held responsible by the Customer. The following are deemed to be cases of force majeure which release SANAREVA from its obligation to fulfil its delivery obligations, in addition to those usually adopted by the French Courts and Tribunals: events of a climatic, pandemic, bacteriological, military, governmental or political nature, acts of government or government administrations, war, civil unrest, accidents, the impossibility of being supplied, and more generally, any other similar circumstance or situation beyond the control of SANAREVA.
For reasons of availability, SANAREVA may exceptionally decide to deliver an order to the Customer in several shipments and or packages, without the Customer having to bear additional delivery costs.
7. Sanareva Savings
7.1 How the Sanareva Savings work
By creating a Sanareva account, the customer benefits from Sanareva Savings.
For each product ordered, the Savings are automatically credited with points corresponding to the product. The total amount earned into your Sanareva Savings vary from one product to another. The customer can see how much they can save on each product.
The customer can then use the Sanareva Savings to reduce the original of the next order. The customer can do this by logging in and clicking ‘Use my Savings’ once on the checkout page. The Sanareva Savings will then be activated by deducting the total amount of the order with the amount corresponding in his/her savings.
At any time, the customer can view his/her Sanareva Savings balance in the "My Account" section and on the checkout page.
Points added to the Sanareva Savings are valid for 365 days from the date of the customer's order. Unused savings will expire after this date.
The Sanareva Savings only generate a price reduction on a future order and can not give rise to a refund. The money accumulated on the Sanareva Savings is immediately available for any following order.
When placing an order, the customer can use Sanareva Savings alongside a promotion code.
If an order is cancelled, either by the customer or by Sanareva.co.uk, the Savings used will be re-credited to the customer's Sanareva account. Points gained for a total or partial order that is later cancelled and refunded will be cancelled.
If the customer does not use all the Savings for an order, the remaining Savings can be used for a future order, within the 365 day validity period.
8. Right of withdrawal
The Customer has the right to cancel an order, without having to give reasons, within a period of fourteen (14) days.
The cancellation period will expire 14 days from the day after the day on which he/she (or someone he/she nominates, other than a carrier) receives the last of the goods.
The right of withdrawal cannot be exercised for orders relating to the supply of Products that have been unsealed after delivery and which cannot be returned for reasons of hygiene or health protection.
To exercise the right to cancel, the Customer must inform SANAREVA by letter to: 4 Impasse de Bel Souleil 31850 Montrabé France or by email at email@example.com his/her withdrawal decision for the order in question by means of an unequivocal statement with the subject "Right of withdrawal" (ex: letter sent by the post or email). The Customer may use the sample withdrawal form reproduced in the annex to the present Terms and Conditions of Sale. By using this option, SANAREVA will send an acknowledgement of receipt of the withdrawal by email to the Client without delay after the request has been processed.
In order to comply with the withdrawal period, the Customer must send his/her communication on the exercise of the right of withdrawal before the expiration of the withdrawal period.
In the event of withdrawal, Sanareva will refund the Customer for the amount of the order, therefore meaning for the amount of the item(s) subject to withdrawal, delivery costs of the shipment of the order (with the exception of additional costs corresponding to a delivery method other than the standard courier service offered by Sanareva) no later than 14 days from the day on which the Customer informed SANAREVA of its decision to withdrawal. SANAREVA will proceed with the refund using the same payment method as that used by the Customer for the initial transaction without incurring any costs for the Customer. The refund will be withheld until the goods are returned.
The costs of returning the Product(s) that are the subject of the withdrawal are the responsibility of the Client, except in the case of an order error caused by SANAREVA. In the latter case only, SANAREVA will bear the direct cost of returning the Product(s) concerned.
It is imperative that the Customer sends back or returns the new and unused Product(s) in its/their original packaging, intact (and unopened) accompanied by all accessories, instructions and other documents included, to SANAREVA at the following address:
4 Impasse de Bel Souleil 31850 Montrabé
The Customer must send or return the new Product(s) without undue delay and in any event no later than 14 days after communicating his/her decision to withdraw. This deadline is met if the Customer returns the Product(s) before the expiry of 14 days.
Upon reception of the package by SANAREVA, if the Product(s) are opened and/or used by the Customer, the customer service department will not be able to proceed with a refund of the Product(s). After this 14-day period or failure to comply with all of the above-mentioned conditions, the Customer no longer has the possibility to withdraw and the order can no longer be subject to any cancellation.
9.1 All Products sold by SANAREVA are covered by the legal guarantee of conformity in accordance with articles L.217-3 and following of the French Consumer Code.
SANAREVA delivers goods that conform to the sales contract and are liable for any defects in conformity that existed at the time of delivery of the goods and that appear within a period of two years from the date of delivery.
The legal warranty of conformity is also applicable to goods with digital elements when these elements are supplied with the goods as part of the sales contract, regardless of whether the digital content or digital services are supplied by SANAREVA or by a third party. A digitally-enhanced good is any tangible personal property that incorporates or is interconnected with digital content or a digital service in such a way that the absence of such digital content or digital service would prevent the good from performing its functions.
SANAREVA shall also be liable for any lack of conformity resulting from the packaging, assembly instructions or installation, if this one was assigned to it by the contract or carried out under its responsibility, or if the incorrect installation carried out by the customer as provided for in the contract is due to shortcomings or errors in the installation instructions provided by SANAREVA.
The goods are declared to be in conformity with the contract, in particular:
If it corresponds to the description, type, quantity and quality, particularly with regard to functionality, compatibility, interoperability, or any other characteristic provided for in the contract;
If it is suitable for any special purpose intended by the Customer, which was made known to SANAREVA at the latest at the time of conclusion of the contract and which the Customer has accepted;
it is supplied with all accessories and installation instructions to be provided in accordance with the contract;
If it is updated in accordance with the contract.
The goods shall also be declared to be in conformity, in parcular:
If it is fit for the purpose usually expected of goods of the same type.
If it corresponds to the quantity, quality and other characteristics, including durability, functionality, compatibility and safety, that the Customer can legitimately expect for goods of the same type, taking into account the nature of the goods as well as public statements made by SANAREVA, by any person upstream in the transaction chain, or by a person acting on their behalf, including in adversing or on labelling..
If the digital elements it contains are provided in the most recent version available at the time of the conclusion of the contract, unless the parties agree otherwise;
If it is delivered with all the accessories, including packaging, and installation instructions that the Customer may reasonably expect;
If it is supplied with the updates that the Customer can legitimately expect.
Defects of conformity that appear within twenty-four months of delivery of the goods shall, unless proven otherwise, be presumed to have existed at the time of delivery, unless this presumption is incompatible with the nature of the goods or the defect claimed.
Where the contract for the sale of goods with digital elements provides for the continuous supply of digital content or a digital service, any lack of conformity which appears at the time of delivery of the goods shall be presumed to have existed:
During a period of two years from the delivery of the goods, where the contract provides for the supply of digital content or a digital service for a period of two years or less, or where the contract does not specify the duration of the supply;
During the period in which the digital content or service is provided under the contract, where the contract provides for such provision for a period longer than two years.
9.2The Customer also benefits from the guarantee against hidden defects under Article 1641 and following of the Civil Code.
Article 1641 of the Civil Code:
« The seller is bound by the guarantee on account of the hidden defects of the product sold which render it unfit for the use for which it is intended, or diminish this use so much that the buyer would not have acquired it, or would only have paid a lower price for it, if he had known about them. ».
Article 1648 of the Civil Code :
« The action resulting from redhibitory defects must be filed by the purchaser within two years from the discovery of the defect. In the case provided for by Article 1642-1, the action must be brought, under penalty of foreclosure, within one year from the date on which the seller can be discharged from the defects or apparent lack of conformity.
Within the context of the guarantee for hidden defects, SANAREVA offers, at the Client's choice, after confirmation of the existence of the defect :
- Or the refund of the full price once the Product has been returned,
- Or a partial refund of the price if the Customer keeps the defective Product;
9.3 To benefit from these guarantees, the Product must be used in accordance with its instructions.
No warranty can be claimed by the Customer if the Product has undergone any modifications or if the Product was damaged during shipping or use. Obvious defects also can not give rise to warranty.
9.4 How to return a Product within the context of its waranty.
If a Customer wishes to benefit from the warranty of a Product, he/she is invited to contact customer service in order to provide the return address of the Product for testing. Sanareva will be responsible for the shipping costs by sending a prepaid return label to the Customer.
Upon receipt and after testing the Product, if it complies with the warranty conditions, the customer service team will contact the Customer to define the warranty implementation terms.
10. Transfer of ownership
After the date of dispatch of the order, the Product ownership is transferred from the Seller to the Customer, except in the case where full payment has not been received by the Seller. Ownership of the delivered product is transferred to the Customer from the date of the reception of the full order payment.
11. Intellectual property
The Site is the exclusive property of SANAREVA and all rights pertaining thereto. Reproduction in whole or in part, is always subject to the authorisation of SANAREVA. However, hypertext links to the site are authorized without specific requests.
The "SANAREVA" brand and all the brands mentioned on the Site are and will remain the exclusive property of SANAREVA or of the holder of the intellectual property rights concerned. Any total or partial reproduction, modification or unauthorised use of the SANAREVA brand, the Site's graphic charter and/or its contents constitutes acts of copyright infringement and/or distinctive sign rights and engages the Client's criminal and civil liability on the basis of copyright infringement and/or distinctive sign rights.
The texts, layouts, illustrations, photos, product sheets and other elements appearing on the Site are protected by copyright and, in general, by the principles of intellectual property law. The content of the Site may not be copied. It may not be modified, placed on another site or published in any form whatsoever without the prior written permission of SANAREVA. The same applies to texts, illustrations and other elements protected by the copyright of third parties.
12.Agreement in relation to proof
SANAREVA may exercise, as proof, any actions, programs, data, file, registration, operation and other elements (such as monitoring reports or other reports) of a nature or in computer or electronic format or support, established, received or retained directly or indirectly, for example in any database.
The Products offered comply with current French legislation. The photos of the Products displayed on the Site are provided for illustrative purposes. SANAREVA cannot be held responsible in the event of a discrepancy between the packaging or content of a Product and the photo of the Product available on the Site.
The Customer, prior to placing an order, declares that he has full legal capacity enabling him/her to commit himself/herself to the present Terms and Conditions of Sale, without SANAREVA's liability being sought in this respect. SANAREVA can under no circumstances be held responsible for verifying the legal capacity of its visitors and Customers. Consequently, if a person without legal capacity places an order through the Site, their legal representatives (parents, guardians, etc.) would assume full responsibility for this order and would have to honour the price.
SANAREVA cannot be held liable in all cases where the non-performance of its obligations is the fault of a third party, even if it is foreseeable, of the Customer, or in the case of the occurrence of an event of force majeure in application of article 1218 of the Civil Code. In particular, are considered as cases of force majeure releasing SANAREVA from its obligation to deliver, in addition to those usually adopted by the French Courts and Tribunals, acts of government or government administrations, war, civil unrest, accidents and the impossibility of being supplied. SANAREVA declines all responsibility in the presence of direct or indirect damages, whether foreseeable or not, caused during the use of the Site.
In any case, if SANAREVA's responsibility is retained because of a prejudice suffered by the Customer exclusively resulting from the placing of the order, the latter will be irrevocably limited to the amount of the order in question paid by the Customer.
14. Personal data
SANAREVA collects and processes the personal data of the Customer and, when appropriate, of the recipient of the order. The Customer declares to have read and accepted without reservation all the provisions contained in the Privacy Charter , by ensuring the uses that may be made by the Seller of the collected personal data.
In application of the General Data Protection Regulation n°2016/679, the Customer has the right to access, rectify, delete, oppose, limit the processing and portability of data concerning him/her. The Customer may exercise these rights by sending a request by post to the following postal address: Délégué à la protection des données personnelles - 4 Impasse Bel Souleil 31850 Montrabé, FRANCE; or by e-mail by contacting: firstname.lastname@example.org. The Client has the right to submit a complaint to a supervisory authority if he considers that the processing of personal data concerning him/her constitutes a violation of the General Regulations on Data Protection and the French Data Protection Act (Loi Informatique et Libertés).
All claims must be addressed to SANAREVA customer services.
Customers can contact SANAREVA customer service from Monday to Friday from 9:00 to 17:00 by mail (email@example.com) or via the contact form available here.
SANAREVA commits to respond to all claims within 3 working days;
Any complaint relating to an error by SANAREVA in the sending of one or more Product(s) within an order, is dealt with by SANAREVA by issuing a prepaid return slip provided by customer service.
The Customer commits to return the unopened and unused Product(s) in their original packaging. SANAREVA will compensate the Customer upon the reception of the Product(s) back in the warehouse that is the subject of the complaint.
In the case of a missing product, not notified in the order, customer service may request a handwritten statement signed by the Customer indicating that he/she has not received the product(s) concerned. The customer service department may open an investigation internally and with its courier service. An internal investigation may take up to 3 working days.
In the event of a claim related to the non delivery of the parcel by the carrier, the customer service will contact the carrier and will open an investigation with the carrier concerned. The carrier's response time varies from 48 hours to 15 days. Upon receipt of the carrier's response and depending on the result, the customer service department may proceed with the shipment of a replacement order, refund or credit, at the Customer's discretion. In order to support any claim with the carrier, SANAREVA reserves the right to request a handwritten and signed statement and a copy of any official identification to certify the non-reception of the goods.
In the event of an error in the order caused by SANAREVA in the order and/or in the event of receipt of one or more damaged Product(s) in an order, customer service may ask the Customer to send a photo of the order and/or of the damaged Product(s) to the email address firstname.lastname@example.org. On receipt of the photo, the customer service department may offer a refund or partial refund or credit on the Customer's Sanareva Savings corresponding to the amount paid. For an amount greater than £10.00, the customer service department may offer a free return label for the return of the damaged or wrong product(s) Customer service reserves the right to request the return of the damaged product(s) by issuing a prepaid return voucher before making any compensation.
15.2 Consumer mediation
In accordance with Articles L.612-1 and following the Consumer Code, all professionals must allow all consumers access to a consumer mediation system for the purpose of resolving any disputes amicably.
The Customer may only refer the matter to a mediator if he can justify having previously made a written complaint to the seller, and this within one year of this written complaint.
In the event of a dispute between the Customer and SANAREVA, the Customer may have recourse to the consumer mediator appointed by SANAREVA, in order to resolve the dispute amicably.
The consumer mediator chosen by SANAREVA is DEVIGNY MEDIATION. The Customer may have recourse to the Consumer mediator via its website available at this link or (ii) by post: MEDIATEUR DE LA CONSOMMATION AGREE DEVIGNY MEDIATION 9, avenue René GASNIER D01 49100 ANGERS.
All costs related to the Customer's recourse to the Consumer Mediator will be covered by SANAREVA.
15.3 Online dispute resolution
In accordance with article 14.1 of the regulation n°524/2013, in the event of a dispute between the Customer and SANAREVA, the Customer has the possibility to file a complaint via the European online dispute resolution platform (LRR) ; available at this link.
16.1 Partial non-validity
If any provision of the Terms & Conditions is found by any law application, regulation or following decision of competent jurisdiction to be wholly or partly invalid it shall to the extent of such invalidity be deemed severable and remaining provisions of the Terms & Conditions and the remainder of such provision shall continue in full force and effect.
All breaches of the present Terms and Conditions of Sale shall only be valid if they are first explicitly accepted by SANAREVA. The explicit waiver of a clause of the Terms and Conditions of Sale does not imply any relinquishment of the application of the other clauses of the Terms and Conditions of Sale.
SANAREVA reserves the right to modify and/or adapt the present Terms and Conditions of Sale at any time. The current Terms and Conditions of Sale are those in force on the day the order is placed by the customer and remain unchanged for the said order despite any subsequent modification.
Should one of the parties not at any time require the strict compliance by the other party with any stipulation or condition of the present Terms and Conditions of Sales, this shall in no way be considered as a definitive waiver of the exercise of this right.
16.4 Governing Law and Jurisdiction
SANAREVA and the Customer agree to comply with the present Terms and Conditions of Sale under French law.
In the event of difficulties encountered with the execution of the Terms and Conditions of Sale, the Customer and SANAREVA encourage an amicable solution before any legal action is taken.
In the event of a dispute and in the absence of an amicable agreement between the Customer and SANAREVA, the courts of Toulouse (France) shall have jurisdiction.
APPENDIX : Model withdrawal form
(To withdraw, please complete this form and return it to us)
4 Impasse Bel Souleil
Email : email@example.com
I/We (*) hereby give notice that I/We (*) withdraw from my/our (*) contract of sale of the following goods (*)/for the provision of the following service:
Ordered on (*)/received on (*):
Name of consumer(s):
Address of consumer(s):
Signature of consumer(s) (only if this form is notified on paper):
(*) Delete as appropriate.