Model Withdrawal Form


(Only complete and return this form if you wish to withdraw from the contract)

 To Rakuten Kobo Inc., 135 Liberty Street, Suite 101, Toronto, Ontario, Canada, M6K 1A7, e-mail address:

 I/We (1) hereby give notice that I/We (1) withdraw from my/our (1) contract of sale for the following goods (1) / for the provision of the following service (1):

 Ordered on (1) / received on (1):

 Name of consumer(s):

 Address of consumer(s):

 Signature of consumer(s) (only if this form is sent in hard copy):





(1) Delete as appropriate.