Withdraw from contract

Your order

No account or reason needed.

Name

Email address

We’ll send the confirmation here.

Order number

It’s on your order confirmation, for example #1001.

What would you like to withdraw from?

The whole order Part of the order

Which products, and how many?

For example: 1 × Fuel System Restore 250 ml.

Received on (optional)

Comment (optional)

Has a bottle been opened, or is it leaking? Let us know here and we’ll send you safe return instructions.

I hereby withdraw from the purchase of the products listed above.

Returns address: ATOMIQ B.V.
Retouren
Sluisweg 200
5237 MZ ’s-⁠Hertogenbosch
The Netherlands
Questions: info@atomiqfuel.com
+31 (0)73 234 07 09Please include your order number.

Prefer to send the form by post or email?

Download the PDF or print the text below, fill it in and send it by post or email. Your own clear statement is fine too.

Send the form by email

Complete and return this form only if you wish to withdraw from the contract.

ToATOMIQ B.V.
Sluisweg 200
5237 MZ ’s-⁠Hertogenbosch
The Netherlands
Email: info@atomiqfuel.com

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

Products and quantities

Order number, if available

Ordered on

Received on

Name of consumer(s)

Address of consumer(s)

Date

Signature of consumer(s), only if this form is submitted on paper

* Delete as appropriate.