#Model withdrawal form

This page reproduces the standard model withdrawal form set out in Annex I, Part B of Directive 2011/83/EU, as required by Article 6(1)(h) of that Directive and Article VI.45 of the Belgian Code of Economic Law.

Using this form is optional. You can withdraw by any unequivocal statement — an email to legal@1fifty.ai saying you wish to withdraw is enough. The conditions, time limit, and effects of withdrawal are set out in Section 5.4 of our Terms of Service.

If you paid through the Apple App Store or Google Play, those stores act as merchant of record and handle refunds under their own policies — see Section 5.5 of our Terms of Service. Where consumer-protection law gives you a stronger right than the store’s policy, that statutory right prevails.

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#The form

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

To: 1fifty BV, Oude Antwerpsebaan 109 bus 102, 2800 Mechelen, Belgium — legal@1fifty.ai

I/We (*) hereby give notice that I/We (*) withdraw from my/our (*) contract for the supply of the following digital service: 1fifty subscription (or purchase identifier, as applicable).

Ordered on (*) / received on (*): _________

Name of consumer(s): _________

Address of consumer(s): _________

Signature of consumer(s) (only if this form is notified on paper): _________

Date: _________

(*) Delete as appropriate.

A signature is only needed if you send the form on paper. Emailing the completed text to legal@1fifty.ai is sufficient.