Official model · free
Withdrawal form to download
The model withdrawal form (annex to European Directive 2011/83/EU, valid throughout the EU) to copy or download, how to fill it in and send it.
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The withdrawal form (also called a withdrawal slip or model form) is the document used to notify a trader of your decision to cancel a distance purchase, within the 14-day period, without having to give a reason. Here it is, free and ready to use.
Official model: model withdrawal form
WITHDRAWAL FORM (Complete and return this form only if you wish to withdraw from the contract.) To: Name of trader: ................................................... Address: ........................................................ E-mail address: ................................................. I hereby give notice that I withdraw from my contract for the sale of the following goods / for the provision of the following service: Ordered on / received on: .................................................. Order number (optional): ........................................ Name of consumer(s): ........................................... Address of consumer(s): ....................................... Date: ................................................................... Signature (only if this form is notified on paper): ..........
Model faithful to the model form set out in Annex I(B) to Directive 2011/83/EU. Downloaded as .txt, it converts to PDF in one click from any word processor. A trader? The panel above pre-fills your details to deliver the form ready for your customers.
How to fill in and send the form
Get the model
Copy or download the form above.
Fill it in
The trader's name and address, the order or delivery date, your details, today's date.
Send it to the trader
By email, by recorded delivery (advised for proof) or via the trader's online withdrawal button.
Keep dated proof
Acknowledgement of receipt, email, screenshot: in the event of a dispute, it is for you to prove that you withdrew within 14 days.
Who must provide this form?
It is the trader. Directive 2011/83/EU requires them (art. 6) to give the consumer, before the order, the information about the right of withdrawal and the model withdrawal form. Failing to provide it extends the customer's withdrawal period.
Since 19 June 2026, a separate obligation applies: a permanent withdrawal button (EU obligation, Directive 2023/2673). The form and the button are complementary: one is a document, the other an online entry point that receives and dates the request.
Frequently asked questions
Is the withdrawal form mandatory?
For the trader, yes: they must provide the consumer with the model withdrawal form together with the pre-contractual information (harmonised by Directive 2011/83/EU, art. 6). For the consumer, no: they can withdraw using this form, but also by any other unambiguous statement expressing their decision to withdraw.
Where can I download the model withdrawal form?
Directly on this page: the official model is reproduced above, with a button to copy it and a button to download it. It is the model form set out in Annex I(B) to Directive 2011/83/EU.
What is the difference between a withdrawal form and a withdrawal slip?
No substantive difference: “withdrawal slip” is a common synonym for “withdrawal form”. Both refer to the same model document used to notify the trader of a decision to withdraw.
Can I withdraw without using the form?
Yes. The form is not imposed on the consumer: an email, a letter or a click on the trader's withdrawal button is enough, as long as the decision to withdraw is clear. The form mainly has the advantage of being complete and of securing the date.
Do I have to send the form by recorded delivery?
It is not mandatory, but it is advisable: in the event of a dispute, it is for the consumer to prove that they withdrew within 14 days. A recorded delivery letter with acknowledgement of receipt, or a withdrawal button that dates the request, provides that proof.
The button generates the form for you
Rather than a paper form, BackToMe sets up a button compliant with the European obligation (Directive (EU) 2023/2673), collects the request and sends the acknowledgement of receipt. 7-day free trial, 0 € today.