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Appendix No. 1

Form of consumer’s withdrawal from the Agreement

LangMedia Sp. z o.o.
ul. Rapackiego 5
53-021 Wrocław

First name of Becorrect website User:

E-mail address from which account on Becorrect website was created:

I hereby inform that I withdraw from the Agreement regarding the use of the Becorrect website.

Day, Signature (only if the form is sent in hard copy)

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