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Withdrawal Form (Annex B of DL 24/2014)

(To be filled out and sent to cocoaconceptshop@gmail.com )

I/we: ________________________________________________
Address: ______________________________________________
CPF: ____________________
Order Number: ____________________
Order Date: ____________________
Signature (if on paper): ____________________
Date: ____________________

Last updated: May 20, 2025