Withdrawal form
Version dated 8 November 2026

POLONA SVETOVANJE, STORITEV, TRGOVINA IN TURIZEM D.O.O.
Strmec pri Leskovcu 48, 2285 Zgornji Leskovec, Slovenija
trgovina@polonadoo.si
+386 2 763 00 07
VAT ID: SI34057315
Company registration number: 2158183
Okrožno sodišče Ptuj

Called-up share capital: 8.986,00 EUR

To: Polona d.o.o., Strmec pri Leskovcu 48, 2285 Zgornji Leskovec, Slovenia; trgovina@polonadoo.si

I hereby give notice that I withdraw from my contract for the following goods:
Products: ____________________
Order number (if known): ____________________
Ordered on / received on: ____________________
Consumer name: ____________________
Consumer address: ____________________
Date: ____________________
Signature (paper submission only): ____________________

This form is optional. Send it only if you wish to withdraw.