Withdrawal Form Template / Right of Withdrawal

(Complete and send this form only if you wish to withdraw from the contract and return your product. For questions or assistance, contact us at contact@le.shoes or +48 690 071 732. Returns are always free within the EU!)


To:
BLEYO Sp. z o.o.
ul. Hoża 86 / 410
00-682 Warsaw, Poland
Email: contact@le.shoes


CUSTOMER DETAILS

  • Full name of customer: ______________________________________
  • Address (street, postal code, city, country): ____________________________________________________
  • Email address: ______________________________________________
  • Phone number (optional): _____________________________________

ORDER DETAILS

  • Order number: ______________________________________________
  • Date of purchase: ___________________________________________
  • Date of receipt of goods: _____________________________________

WITHDRAWAL STATEMENT

I hereby give notice that I withdraw from my contract of sale for the following products (please specify):

  • Product name(s) and quantity:


Reason for withdrawal (optional):


You do not have to provide a reason – this is optional.


RETURN ARRANGEMENTS

  • The product(s) will be returned in:
    □ Original packaging
    □ Alternative secure packaging
  • All accessories/manuals included: □ Yes / □ No

REFUND DETAILS

  • Please refund the purchase amount to:
    □ The original payment method
    □ Alternative account (if applicable, provide IBAN/BIC):


DECLARATION

I understand that my right of withdrawal is valid for 14 days from the date of receipt of the goods, in accordance with the law and the store’s return policy.
I declare that the information provided above is complete and true.


  • Date of submission: _________________________
  • Customer signature (only if submitted in paper form): ___________________________

INSTRUCTIONS

  1. Complete this form and send it to us by email (contact@le.shoes) or include it in your return package.
  2. You will receive a prepaid return label via email or with your original package.
  3. Pack the products securely, attach this form inside the parcel, and use the provided return label.
  4. As soon as we receive the returned items, your refund will be processed within 14 days.
  5. For further details, please refer to our Return Policy at www.le.shoes/returns

All personal data provided will be processed solely for the purpose of handling your withdrawal request and refund, in accordance with our Privacy Policy and GDPR.