General Terms and Conditions

These General Terms and Conditions (hereinafter referred to as the “General Terms and Conditions” or the “GTC”) apply to contracts, which are concluded through an online shop,  Gravelli E-shop located at jewellery.gravelli.com (hereinafter referred to as
the “Web interface”) between our company

Gravelli s.r.o.,
ID: 294 41 200,
VAT No.: CZ29441200,
Registered office at Pod Harfou 3/3, Vysočany, 190 00 Prague 9, Czech Republic,
Registered in the Commercial Register, by the Municipal Court in Prague under No. 233128,
Delivery address: Pod Harfou 3/3, Vysočany, 190 00 Prague 9, Czech Republic,
Phone number  (+420) 737 427 491,
Contact e-mail: shop@gravelli.com

Hereinafter referred to as “the Seller”

and

You, the Buyer (hereinafter referred to as “the Buyer”)

1. Initial statements

1.1 What do the following statements, that begin with capital letters and are marked bold,in this GTC stand for?

The “Online shop” in this GTC stands for an e-shop, the jewellery.gravelli.com belonging to the Seller, operating through the Web interface.

A “Purchase Agreement” in this GTC means a Purchase Agreement for Goods under these General Terms and Conditions concluded between the Buyer and the Seller.

The “Buyer” in this GTC stands for both a consumer and a legal entity.

The “Civil Code” in this GTC stands for the Act No. 89/2012 Coll., of The Civil Code of the Czech Republic, and its later amendments.

A “Legal entity” in this GTC, stands for a legal entity, compliant with the Article 420 of the Civil Code being the Buyer, who makes an order at the Seller’s Web Interface, and who acts independently on his / her own account and responsibility, while the goal of their action is a gaining of a profit or an intention to do so, in a business-like manner with the purpose of gaining a profit, as well as such a customer of the Seller’s Web Interface who operates on his / her own responsibility related to his / her own business or a similar activity, independently, from the title of his / her profession, or a person acts in the name or on behalf of a legal entity, compliant with the Section 420 (1) of the Civil Code of the Czech Republic.

“the Seller” in this GTC is the Gravelli s.r.o., Identification number 294 41 200, Registered Office at Pod Harfou 3/3, Vysočany, 190 00 Prague 9, Czech Republic, established and operating under the law of the Czech Republic and registered in the Commercial Register of the Czech Republic at the Municipal Court in Prague under the No. C 233128, which is a legal entity in the meaning of Section 420 of the Civil Code. If the Buyer is in these Terms and Conditions addressed to, they are addressed to in that manner by the Seller.

A “Complaints Procedure” in these General Terms and Conditions refers to the Seller’s Complaint Procedure, which sets out the procedures for exercising customers right to submit a complaint about defective Goods within the legal time limit. The Complaint Procedure terms are an integral part of these GTC.

“Parties” in these General Terms and Conditions refer to the Seller on the one side and the Buyer or more Buyers on the other.

“Consumer” in these General Business Terms and Conditions means any person who, within of his or her independent business or business, concludes a contract with the Seller or otherwise interacts with the Seller and is also the customer of the Seller’s Online shop. As for the interpretation of the term “consumer”, the interpretation of this term is adequately interpreted in the provisions of Section 419 of the Civil Code.

“Goods” in these General Business Terms stand for a jewellery and accessories.

1.2 What is our legal relationship?

Our legal relationship is regulated by following documents:

• These General Business Terms and Conditions which, within the meaning of Section 1751 (1) of the Civil Code, define and specify our mutual rights and obligations arising from the Purchase Agreement;
• Complaints Procedure according to which we will process complaints about defective performance,
• the terms and conditions stated on the Web Interface, especially when signing the contract;
• By your order and its acceptance by us, and in matters which may not regulated by this GTC then by the relevant laws of the Czech Republic, in particular, the Civil Code.

If your domicile or your head office is located and registered outside the Czech Republic, or if our legal relationship contains any other international element, please note that our legal relationship is governed by the Czech law. If you are a Consumer and the law of your country of residence, provides you with a higher level of consumer protection than the Czech law does, then that higher level of protection will be provided to you in legal relationships.

1.3 How do you agree to the General Terms and Conditions?

By submitting your order and by confirming it on the Web Interface means that you confirm that you have become familiar with and agree to these General Terms and Conditions, including the The Complaints Procedure and the consent to the processing of personal data that is to be found …, have become familiar with and agree with them.

2. Purchase Agreement

In the Purchase Agreement we agree to deliver to you the Goods as described in your order and you are obliged to receive the Goods (either in person or claim them from a carrier) and pay us the Purchase Price for the Goods ordered by you (referred to as the “Purchase Price“), including any fees related to the chosen method of paymentspecified in your order. The Purchase Price includes VATand including the amount of the duty.

You acquire ownership of the Goods by paying the full Purchase Price and fees for the chosen payment method, but not before you receive the Goods.

2.1 Is the Purchase Contract a consumer contract?

The Consumer Contract is the case if you are a Consumer. Otherwise, the consumer contract is not applicable and you are not subject to the Consumer Protection neither under the law and these General Terms and Conditions. If you are not a Consumer, you do not have the Consumer’s rights specified in these GTC.

2.2 How do we enter the Purchase Agreement?

A list of Goods is included on the Web Interface, including a description of the main features of each item. For each of the Goods, the Purchase Price including all taxes and customs is displayed. The presentation of the Goods on the Web Interface is informative and is not our proposal to conclude the Purchase Contract, in accordance with Section 1732 (2) of the Civil Code. To conclude the Purchase Agreement, you must make an order and receive it.

2.3 How to make an order?

You can always make an order via the Web Interface (by completing the form), or by telephone, e-mail or other means, according to current information provided on the Web Interface.

The order must contain all the information necessary to fill in the form, in particular, the exact indication of the Goods ordered (or the Goods Identification number), the number of items, the chosen method of payment and shipping and your contact details (shipping and invoicing).

Before the final submission of an order is sent, you will be notified in a recap of the order you are making, including the final Purchase Price and including all charges (depending on the mode of transport and payment chosen). We recommend that you check especially the type and quantity of Goods, e-mail and delivery address. You have the last chance to change the entered data before agreeing to the recap.

You will submit a binding order by pressing the “Finish Order” button. We consider the information given in the binding order to be correct and complete. We will inform you by telephone or e-mail about their change without delay.

We will inform you when we receive your order. The order information (confirmation) is sent automatically and is not a confirmation of the order by us unless expressly stated in the confirmation.

If we have any doubts about the authenticity and seriousness of an order, we may contact you for verification. We can decline to process an order. Such an order is considered as if it has never been submitted.

2.4 When does the Purchase Agreement become effective?

The purchase agreement becomes effective when an order is accepted by us. Acceptance of an order, including the GTC and the Complaints Procedure, will be sent to the e-mail address you provided in the order. Acceptance of the order may be part of the order receipt information referred to in Article 2.3 of these General Terms and Conditions (if expressly stated in the confirmation) or may follow that confirmation separately.

Information on individual technical steps leading to the conclusion of the Purchase Agreement can be seen in the Web Store Web interface.

2.5 Can you cancel your order?

Until we do not confirm an order we have received (if you have not received a confirmation of an order from us, pursuant to Article 2.4 of these General Terms and Conditions), you can cancel by phone or e-mail. All orders confirmed by us are binding. Later cancellation of an order is possible only after agreement with us, if the ordered Goods, for which it is not possible to withdraw from the Purchase Agreement (more details about the possibility of withdrawing from the Purchase Agreement in Article 5 of these General Terms and Conditions), we are entitled to a reimbursement of the costs we have suffered in connection with the Purchase Agreement conclusion.

2.6 Can the Purchase Price listed in the online store change?

The prices of the presented Goods remain valid for as long as they are displayed on the Web Interface Web of the Online Shop. Discounts on the Purchase Price on the Goods cannot be combined unless otherwise explicitly stated on the Web Interface.

In the event that the Purchase Price of the Goods in the Online Store or during the ordering process, is really obviously wrong due to a technical error on our part, we are not obliged to deliver the Goods at that Purchase Price, even if you have been sent a confirmation of the order under these General Terms and Conditions. In such a case, we reserve the right to withdraw from the Purchase Agreement.

If the Purchase Price listed on the Goods at the Online Store Web Interface is no longer up to date, we will immediately notify you about this. If your order has not yet been accepted, we are not required to conclude the Purchase Agreement.

The change in the Purchase Price that occurs between the time the order is being sent and its acceptance by us. that price does not apply in compliance with Article 2.4 of these General Terms and Conditions.

2.7 In which languages can the Purchase Agreement be concluded?

The Purchase Agreement can be concluded in the Czech and Englishlanguage unless we expressly agree on another language.

2.8 Do you get the purchase agreement in text form?

The purchase contract is not concluded in writing with the signatures of the contracting parties. The Purchase Agreement consists of the following Terms and Conditions, of your order and its acceptance by us. The entire Purchase Agreement will be sent to you by e-mail or printed and posted at your request. We may ask you to compensate to us the cost of the postage.

2.9 Is the Purchase Agreement stored anywhere?

We store the Purchase Agreement (including these General Terms and Conditions) in electronic form. The purchase agreement is not accessible to any third party, but we will send it to you at your request.

2.10 What if you do not understand something in the Purchase Agreement?

If you have any question regarding the Purchase Agreement, you can contact us by phone or e-mail. We will be willing to provide you kindly with all the necessary information.

3. Payment Conditions

3.1 What kind of payment methods we accept?

You can pay the Purchase Price online before shipping the Goods in the following ways:

• Online CardPayment
• By transfer in favour of our bank account (instructions will be sent to you by e-mail in the order confirmation).

Some forms of payment may be further charged. These fees are listed on the Web Interface. The order will always show the final Purchase Price that includes all fees associated with the payment method you choose.

3.2 When is the Purchase Price due?

The Purchase Price including all fees is due within five working days as of the date of the conclusion of the Purchase Agreement in compliance with the Article 2.4 of these GTC. Your obligation to pay the Purchase Price, including all charges, is fulfilled when the price is paid and when the relevant amount is credited to our bank account.

3.3 In what currency can you pay?

Payment may be sent in Czech Crowns (CZK) or Euros (EUR).

3.4 When can we require a deposit or prepayment?

We may request a deposit on the Purchase Price especially for orders with a total Purchase Price of over CZK 5,000.

We are also entitled to request you to pay the entire Purchase Price of the Goods before the order is dispatched ((Section 2119 (1) of the Civil Code does not apply).

4. Delivery Terms

4.1 How do we ship the Goods?

Delivery Methods are listed on the Web Interface. You can choose a specific way of delivery of the Goods before sending your order.

4.2 What are the costs of shipping Goods within the European Union?

We ship the goods free of charge, so you do not have any additional shipping costs.

4.3 What are the costs of shipping Goods outside of the European Union?

Any of the Goods shipped outside the European Union are shipped for an additional fee of 30 EUR.

4.4 When will we deliver the Goods?

The delivery time of the Goods always depends on the Goods availability and on the chosen way of transport and payment.

Goods that are in stock are usually shipped within two business days of crediting our account.

Goods that are not in stock will be shipped as soon as possible. We will inform you of the exact date.

Delivering Goods under these General Business Terms means the moment when you either take over the Goods in person or you claim them from a courier. If you without a reasonable cause refuse to take over the Goods, it is not considered to be a violation of our obligation to deliver the Goods to you, neither is it considered to be your withdrawal from the Purchase Agreement.

4.5 How to proceed to take over the Goods?

Check the integrity of the Goods package while taking it over. If you notice any deficiencies, inform the carrier immediately. If you refuse to accept a damaged shipment, it is not considered to be an unreasonable refusal to take over the Goods.

The moment you take over the Goods (or the moment when you were obliged to accept the Goods, but you fail to do so, in contravention with the Purchase Agreement), you are liable for the accidental destruction, damage or loss of the Goods.

4.6 What happens if you do not take over the Goods?

If for reasons on your side, it is necessary to deliver the Goods repeatedly or otherwise than was agreed, you are obliged to pay the costs of such delivery.

In the event that you unreasonably do not take over the Goods, we are entitled to reimbursement of the costs of the delivery of the Goods and storage of the Goods as well as any other costs incurred by your failure to take over the Goods. These costs will not exceed CZK 10per day of storage. The storage costs may reach a maximum of CZK 500 or an amount up to the Purchase Price if it is lower than CZK 500.

We also have the right to withdraw from the Purchase Agreement in such a case.

If you do not take over the Goods due to a damaged package, that may indicate an unauthorized intrusion into the shipment, you will not be liable in the sense to the above, to cover any delivery costs incurred. In such a case, you are only required to immediately notify this the carrier and our company.

5. The Consumer’s right to withdraw from the Purchase Agreement

5.1 How can you withdraw from the Purchase Agreement if you are a Consumer?

If you are a consumer, you have the right to withdraw from the Purchase Agreement within 14 days of the date of delivery of the Goods, if the Goods are delivered in several parts, then from the date of delivery of the last shipment. In order to comply with the withdrawal period under the previous sentence, it is advised to send a notice of withdrawal from the Purchase Agreement before the expiration of the relevant period. We strongly advise sending notice of withdrawal from the Purchase Agreement to our office address or e-mail address. In order to withdraw from the Purchase Agreement, please use the template form, which is attached to these GTC. We will confirm the acceptance of the withdrawal from the Purchase Agreement notice without undue delay.

You do not have to justify your reason for the withdrawal from the Purchase Agreement.

5.2 What are the consequences for withdrawing from the Purchase Contract if you are a consumer?

By withdrawing from the Purchase Agreement, the Purchase Agreement is cancelled as a whole and viewed it as if it had never been concluded.

If a free gift has been included in your order, with your consent, the Gift Agreement will be terminated in the moment of cancellation of the Purchase Agreement by any of the Contracting Parties. Please return your gift back together with the Goods.

5.3 When consumers cannot withdraw from the Purchase Agreement?

In compliance with the Article 1837 of the Civil Code, it is not possible to withdraw, ie. from contracts for the delivery of Goods which have been adjusted for you or according to your wishes.

5.4 How to return the Goods to us in case of withdrawal from the Purchase Agreements?

You are required to return the Goods within 14 days as of the withdrawal from the Purchase Agreement, sending the Goods to the address Pod Harfou 3/3, Vysočany, 190 00 Prague 9, Czech Republic. This deadline is considered to be satisfied if you have sent us the Goods before it expired.

Do not send the Goods by COD. We are not obliged to take over any shipments sent by cash on delivery. The costs associated with sending the returned Goods to us are always your expenses, even if the Goods cannot be returned by regular mail.

We recommend that with the returned Goods you include:

• a copy of the delivery note and invoice, if these documents were issued, or another document proving the purchase of the Goods,
• a written notice of withdrawal from the Purchase Agreement (on our form or otherwise). In your notice please include your delivery address, phone number, and e-mail address.

Failure to submit any of the above documents does not impede with the successful settlement of your withdrawal from the Purchase Agreement in compliance with the law.

5.5 When do you get your money back?

We will refund you within 14 days as of the date of withdrawal from the Purchase Agreement. Please note, however, that we are not obliged to return your money before you return the Goods or prove that you have sent us the Goods.

The money will be refunded to you:

• the way we accepted it, or
• the way you prefer

In addition to the above, we can always return the money by sending it to your bank account or the account from which the funds have been credited to our account as the Purchase Price (if you do not provide us other account details within 10 days following withdrawal from the Purchase Agreement). By accepting these General Terms and Conditions, you agree to that the refund is processed as described in the preceding sentence, provided that it does not incur any additional costs to you.

5.6 What if you return damagedGoods?

When shipping, pack the Goods in a suitable container to avoid damage or destruction.

The 14-day withdrawal period from the Purchase Agreement serves, in particular, to test the functional properties of the Goods, to the extent of the demonstration and testing of the Goods in the regular Store.

If we find that Goods returned to you are damaged, worn out, contaminated or partially consumed, you are liable for this deprecation of the Goods.

By accepting this GTC, you acknowledge that if we find that returned Goods have a damaged seal inside the Goods, you are responsible for the loss of value of the Goods due to the damage was done to the seal.

6. The Right of the Seller to withdraw from the Purchase Agreement

6.1 When can we withdraw from the Purchase Agreement?

We reserve the right to withdraw from the Purchase Agreement in the following cases:

• a totally obviously incorrect price of Goods was displayed on the Web interface due to a technical error (Article 2.6 of these General Terms and Conditions)

• The Goods you have ordered cannot, for certain reasons (mainly because the Goods are no longer manufactured, the supplier ceases to supply them to the Czech Republic, etc.) cannot be delivered due to noncompliance with these GTCs conditions
• Fulfillment of the Purchase Agreement becomes objectively impossible or unlawful.

In the event of any of the above, we will promptly inform you of our withdrawal from the Purchase Agreement. Withdrawal becomes effective when you receive it.

If you have already paid the full price, or paid in advance the Purchase Price, we will refund the amount received to the account you provide to us for this purpose or from which you have made the payment. We will refund the money within five days as of withdrawal the Purchase Agreement.

7. Rights in the case of Defective Performance

Your rights in case of the Goods defective performance are compliant with the generally applicable legal regulations of the Czech Republic (in particular the Article 2099 to 2117 and, if you are the Consumer, the Article 2158 to 2174 of the Civil Code).

When exercising your right to submit a complaint about the defective performance of our Goods, we will proceed in compliance with our Complaints Procedure. Before submitting your complaint, please make sure you make a thoroughly read and understand the Complaints Procedure so that your complaint may be processed as quickly as possible and to your satisfaction.

7.1 What are your rights in case of defective performance if you are a consumer?

In accordance with Article 2161 of the Civil Code, we are responsible that the Goods you have ordered are not defective at the time of taking over, ie in particular when you took over the Goods and

• the Goods have the properties that we have agreed to and if there was no agreement, the Goods have properties that the Goods were described to have or which you expected with regard to the nature of the Goods and our advertising
• the Goods are fit for the purpose for which it is used for or is, the product of this kind normally used
• the quality or performance of the Goods correspond to those of the agreed sample or original, if the quality or design was agreed on according to that sample or template
• the Goods are in the appropriate quantity, degree or weight and meet the requirements of legislation.

In compliance with Article 2161 (2) of the Civil Code, in relation to you, if a defect in the Goods occurs within six months from the date of receipt, it is considered that the Goods were defective already upon delivery.

In compliance with the provisions of Article 2165 (1) of the Civil Code, you are entitled to claim the right to report a complaint about a defect that occurs on the consumer Goods within twenty-four months of delivery. While that does not apply:

• to the Goods sold at a lower price for a defect for which a lower price has been agreed
• to the depreciation of the Goods due to its usual use
• to the used Goods for a defect corresponding to the degree of usage and depreciation of the Goods as it was at the time of your take over
• if it arises from the nature of the Goods.

In accordance with the Article 2169 of the Civil Code, if the Goods do not have the characteristics mentioned in Section 2161 of the Civil Code, you may also request the delivery of new Goods without defects unless it is inadequate due to the nature of the defect but if the defect relates only to components of the Goods, you can only request replacement of those components, if this is not possible, you may withdraw from the Purchase Agreement. If, however, due to the nature of the defect, it is unreasonable, especially if the defect can be repaired without undue delay, you have the right to have the defect removed free of charge. You may also have the right to deliver new Goods, or a part of the Component if there is a defect that cannot be remedied if you cannot properly use the Goods for recurring defects after repair or for multiple defects. In such case, you also have the right to withdraw from the Purchase Agreement. If you do not withdraw from the Purchase Agreement or if you do not exercise the right to deliver new Goods without defects, to replace its parts or to repair the Goods, you may request a reasonable discount from the Purchase Price. You have the right to a reasonable discount even if we cannot deliver any new Goods without defects, replace the part or repair it, as well as in the event that we do not repair or remedy the situation within a reasonable time or that the remedy will cause you serious difficulties.

In compliance with the Article 2170 of the Civil Code, you are not entitled to submit a complaint about defective performance if you knew that the Goods had defects or you caused the defect before taking over the Goods, especially by an unprofessional manipulation or assembly of the Goods.

8. Intellectual Property Rights

By entering the Purchase Agreement, you donot acquire any intellectual property rights to the Seller’s intellectual property rights or the intellectual property rights of others. You are not authorized to create derivative works based on purchased Goods or the Goods displayed on the Web Interface. Furthermore, you are not authorized to use the trademarks, logos, graphics and the name of the Seller in any way.

9. Changes to these General Business Conditions

9.1 Are these General Business Terms final?

This GTCis not final. We are entitled to change these GTC at any time, for example, due to changes in applicable laws. By using the Internet Store after such a change and sending of the order expresses your consent to the amended GTC or, as the case may be, to your amended consent to the processing of personal data.

Any changes to these General Terms and Conditions will not be applied retrospectively, so you are bound by the General Terms and Conditions that were effective at the time of sending your order.

9.2 What if you disagree with these General Terms and Conditions?

If you disagree with the these GTC or any of their parts, you have the right to contact us to discuss your counter-proposal with us. If in a mutual agreement, we may enter into a separate agreement that will take precedence over these General Terms and Conditions.

10. Applicable Law and Judicial Competence

These GTC and the use of the Internet Store are compliant with the law of the Czech Republic. The law of the Czech Republic takes precedence over this GTC, however, if their use is necessary, they will be used in the sense allowed by the Czech law to the widest extent possible.

By using the Online Store, you agree to the above legal terms if you can validly give such consent. We as the Seller will also agree with such a choice.

11. Final Statements

11.1 What rights do we have to carry out our business and who controls us?

We are authorized to sell the Goods based on a trading license. Our activity is not subject to any other authorization.

The trade license is carried out within the scope of its competence by the relevant Trade Licensing Office. Verification of Compliance with the Technical Requirements on Goods and Safety Goods are carried out by the Czech Trade Inspection Authority (http://www.coi.cz/). The Czech Trade Inspection Authority also carries out a review of compliance with consumer protection regulations. Consumer rights are defended by their interest associations and other entities to protect them.

11.2 How do we handle complaints?

We handle any complaints through our contact e-mail. You can also contact the entities listed in Article 12.1. In relation to our customers, we are not bound by any code of conduct and we do not respect such thing.

11.3 What are your rights in a consumer dispute?

If you are a Consumer, in case a dispute arises between us from the Purchase Contract, which we will not be able to resolve together, you have the right to contact the Czech Trade Inspection (Czech Trade Inspection Authority, Central Inspectorate – ADR, Štěpánská 15, 120 00 Praha 2, web interface: www.coi.cz, www.adr.coi.cz, electronic contact: adr@coi.cz, phone: +420 296 366 360) for out-of-court settlement of consumer disputes. You may claim this right within one year from the date you first applied to us the right that is the subject of this consumer dispute.

You can also use the online platform established by the European Commission at http://ec.europa.eu/consumers/odr/ to file a complaint about the Goods that you have purchased with us at http://ec.europa.eu/consumers/odr/..

11.4 What else you should know?

At the conclusion of the Purchase Contract, means of distance communication (especially the Internet) are used. Costs incurred when using distance communication devices (especially Internet or telephone costs) are covered by you. These costs do not differ from the standard rate.

Unless otherwise agreed, all correspondence relating to the Purchase Agreement between us shall be in writing, by e-mail, by registered mail or by personal delivery. As for our part, we will use the email address included in your order details or in your user account set up on the Web interface.

In the event of a discrepancy between the Czech and English versions of this GTC, the Czech version applies.

In the event that any provision of these General Terms and Conditions is void, ineffective, or inapplicable (or becomes), a provision which, by its very nature, closes most closely with an invalid, ineffective or unenforceable provision is used instead. The invalidity, ineffectiveness or inapplicability of one provision is without prejudice to the validity of the other provisions. Changing or supplementing the Purchase Agreement (including the General Terms and Conditions) can only be made in writing.

The seller is not obliged to accept an order that has clearly been made by mistake due to technical or other reasons.

These General Terms and Conditions are valid and effective as of 1.10. 2018

Annex no. 1 The General Terms and Conditions

A sample form for withdrawal from the Purchase Contract in accordance with the provisions of Section 1820 (1) char. f) Civil Code within the meaning of Government Decree No. 363/2013 Coll.(fill in this form and send it back only if you wish to withdraw from the Purchase Agreement)

Notice of withdrawal

Addressee:

Gravelli s.r.o.,

Company identification number: 294 41 200,
Tax identification number: CZ29441200,

registered office: Pod Harfou 3/3, Vysočany, 190 00 Prague 9, Czech Republic,
registered in the Business Register maintained by the Municipal Court in Prague under the file C 233128,
Mailing address: Pod Harfou 3/3, Vysočany, 190 00 Prague 9, Czech Republic,
phone number: (+420) 737 427 491,
contact e-mail: shop@gravelli.com

I declare (*) that I am hereby (*) withdrawing from the purchasing agreement for the purchase of these goods (*) / the provision of these services (*)

Order date (*) / date of receipt (*)

Name and surname of consumer / consumers

Address of consumer / consumers

Signature of consumer / consumers (only if this form is sent in paper form)

Date

(*) Remove an appropriate data or complete the data.