TERMS OF USE

PRELIMINARY ARTICLE 

The company KORLOFF S.A (hereinafter referred to as "KORLOFF PARIS") markets KORLOFF PARIS branded items in Euro area Europe. In order to provide the best possible service to its customers, KORLOFF PARIS wished to set up, in addition to the network of shops it operates, a network of remote sales by electronic means (Internet) of some of its jewelry products. and watchmaking. In order to guarantee its new service to its customers, KORLOFF PARIS wished to offer a selection of certain articles and exclude certain categories of articles from its remote offer. The articles offered in the context of distance selling can be viewed on the website www.korloff.com. The system thus set up, which presupposes an active approach on the part of the customer, is in all respects in accordance with the legal and regulatory requirements of French law required for distance selling. The use of the distance selling process described in these general conditions of sale is reserved for consumers only (hereinafter "Customer (s)"), as defined by law and case law, acting exclusively for their own account and domiciled in one of the following countries: France, Germany, Austria, Belgium, Cyprus, Spain, Estonia, Finland, Greece, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Portugal, Slovakia, Slovenia, Monaco.

ARTICLE 1: FIELDS OF APPLICATION

These general conditions of sale (hereinafter the "GTC") are applicable to all sales of KORLOFF PARIS items concluded via the Korloff merchant site accessible at the following address www.korloff.com (hereinafter the "Site "), For delivery to France, Germany, Austria, Belgium, Cyprus, Spain, Estonia, Finland, Greece, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Portugal, Slovakia, Slovenia, Monaco.

The Customer declares to have read these general conditions of sale and to have accepted them by checking the box provided for this purpose, before placing their order. The validation of his order therefore implies acceptance without restriction or reservation of these general conditions of sale. In accordance with the provisions of article 1127-1 of the Civil Code, these general conditions of sale can be kept by any person visiting the Website www.korloff.com, by means of a computer record and can also be reproduced by the Client, by means of their printing. These GTC may be subject to modifications, the version applicable to the purchase of the Customer is that in force on the Site on the date of placing the order. These general conditions of sale will apply as long as they appear on the Website www.korloff.com. In the event that, after the date of their removal from the Website www.korloff.com, these general conditions of sale would nevertheless remain accessible to the public via other websites or by any other means, they would however no longer be opposable to the company Korloff Paris.

ARTICLE 2: IDENTIFICATION OF THE SELLER

The items are sold by KORLOFF S.A. HEAD OFFICE: KORLOFF S.A - 20 RUE DE LA PAIX - 75002 PARIS. SA with a capital of 3,000,263.25 euros. Registered in the Paris Trade and Companies Register under number: 319 597 456. Intra-community VAT number: FR 513 195 974 56. Telephone: +33 (0) 4 78 17 39 00. Email address: contact@korloff.com

ARTICLE 3: INFORMATION RELATING TO THE ARTICLES

Information relating to all of the KORLOFF PARIS items likely to be sold, on the Website www.korloff.com, is available, with their references, on the said Website as well as in all of the Korloff stores in FRANCE.

The Customer is required to refer to the description of each article in order to know its essential properties and characteristics, before placing any order. This information complies with the prescriptions required by the legal and regulatory texts in force and in particular,

by articles L. 111-1 and L221-5 and following of the Consumer Code and by the ministerial decree of December 3, 1987 "relating to consumer price information. "

All information concerning the weight of precious materials and the number of stones and carats are given as an indication and may vary slightly (each piece is unique and its artisanal manufacturing process justifies a slight difference in the weights of the materials).

For jewelry, this information refers to metric 52 for rings and metric 17 for bracelets. The photographs and graphics of the products offered for sale on the Site are only indicative.

Thus, despite all the care that KORLOFF PARIS takes in the presentation of its articles on its Site, KORLOFF PARIS cannot guarantee that their actual appearance exactly matches their appearance on the screen.

Shade variations may in particular occur, in particular due to the technical limitations of color rendering of computer equipment. KORLOFF PARIS cannot be held responsible for non-substantial errors that may occur.

KORLOFF PARIS reserves the right to modify the assortment of items offered for sale on its Site at any time, without prejudice to orders placed by the Customer and accepted by KORLOFF PARIS.

The offers of articles are valid as long as they are visible on the Site and within the limit of available stocks. Only items with an "Add to cart" button can be sold through the Site.

For any question relating to the articles and their use, any additional question or request for advice, the Customer can contact the team of KORLOFF PARIS advisers by contacting customer service in accordance with the means described in the "Contact" section of the Site.

ARTICLE 4: ORDERS OF ARTICLES

4.1 Internet orders

Orders can be placed via the Internet on the Merchant Site accessible via the address www.korloff.com. The Customer shall bear the telecommunications costs when accessing the Internet and using the www.korloff.com Site.

ACCOUNT REGISTRATION AND VALIDATION OF VISITOR PURCHASES.To place an order, the Customer can either create an online account and identify himself before ordering, or place an order as a visitor without creating an online account by selecting the "As a guest" option. When he places an order as a visitor, a customer account will nevertheless be created in Korloff Paris internal systems in order to register his purchase (s).

In the event of prolonged inactivity during connection, it is possible that the selection of items chosen before this inactivity is no longer guaranteed. The Customer will be invited to resume his selection of products from the start.

All the steps necessary for the sale will be specified on the Website www.korloff.com in accordance with the provisions of article 1369-1 of the Civil Code. In application of the provisions of article 1369-2 of the Civil Code, the Customer will have the possibility,

before definitively validating his order, to verify the details of his order and its total price, and to correct any errors, before confirm this to express acceptance.

From the moment the Customer validates his order, KORLOFF PARIS will acknowledge receipt thereof without delay and by electronic means.

However, the sale will not be considered effective, and the sales contract formed, only after the sending to the Customer of the order confirmation by the company KORLOFF PARIS by email.

Only the items dispatched will be invoiced with any transport costs.

4.2 Refusal of orders

In accordance with the provisions of article L.121-11 of the Consumer Code, KORLOFF PARIS will be able to refuse any abnormal order. In addition, KORLOFF PARIS will be entitled to refuse any new order from a Customer with whom there is a dispute relating to a previous order.

ARTICLE 5: PRICE OF ITEMS

The price of the items is inclusive of all taxes, plus shipping costs. It is expressed in euros. The price including tax of each item that the Customer would like to acquire as well as the amount of any transport costs

relating to their delivery will be indicated to him before the final confirmation of the order by the Customer. The payment requested from the Customer corresponds to the total amount of the purchase of the

articles concerned, including these possible costs. The Customer must explicitly recognize his payment obligation, before confirming his order, by checking the box "Order with payment obligation".

The Customer will receive:

• by email, a written confirmation of the order to which these GTC are attached (including the standard withdrawal form) and mentioning the essential characteristics of the items ordered, the price paid and any delivery costs;

• to the billing address, upon delivery, for each item, a paper invoice detailing the price of the items and any delivery costs payable by them.

It should be noted that the VAT applied is French VAT.

KORLOFF PARIS recommends that the Customer keep the confirmation sent by email on paper or electronic media. In the event of non-receipt of these emails, it is recommended that the Customer check that they have not been lodged in the spam emails.

The Client is informed that emails are sent to the email address entered by the Client. Also, in the event of an error in entering the e-mail address concerned, or in the non-receipt of the message confirming the dispatch of the order,

KORLOFF PARIS cannot be held liable. In this case the sale will be considered final, except in the case of cancellation of the order by KORLOFF PARIS, in particular for unavailability of the articles, default of payment or suspicion of fraud.

The Customer may nevertheless exercise his right of withdrawal under the conditions provided for in article 8 of the General Conditions of Sale.

KORLOFF PARIS reserves the right to modify its prices at any time, subject to current orders. The applicable prices are therefore those in force on the day the Customer places the order.

ARTICLE 6: TERMS OF PAYMENT

Payment for the Customer's purchases on the Site can be made by bank card (cards from the "CB" network, Visa, Eurocard / Mastercard, American Express are accepted). The Customer's credit card is debited when the order is prepared.

To this end, the Customer guarantees to the company KORLOFF PARIS that he is the holder of the bank card and that the name appearing on this bank card to be debited is indeed his then communicates in a secure environment on the Internet,

the number and the date of expiration, appearing on the front of his bank card, as well as, if applicable, the visual cryptogram numbers appearing on the back (or front) of his bank card. In the context of Internet payments, and in order to combat Internet fraud,

control will be carried out online with the competent banking establishments and organizations, questioned via the STRIPE system. The data transmitted by the Customer relative to his bank card are processed in accordance with the policy relating to cookies and the protection of personal data, accessible on the Site www.korloff.com. In the event that, for any reason whatsoever (opposition, refusal by the issuing center, etc.), the debit of the sums due by the Customer proves impossible, the purchase process on the Website will be canceled.

ARTICLE 7: DELIVERY

•           Home delivery

Subject to the provisions of the paragraph below, the delivery of articles may only take place at the Customer's permanent home, or at his professional address, located in one of the following countries:

France, Germany, Austria, Belgium, Cyprus, Spain, Estonia, Finland, Greece, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Portugal, Slovakia, Slovenia, Monaco.

The Customer also has the option of having the articles delivered to one of the natural persons of his choice whose permanent domicile is located in France, Germany, Austria, Belgium, Cyprus, Spain, Estonia, Finland, Greece,

Ireland, Italy , Latvia, Lithuania, Luxembourg, Malta, Netherlands, Portugal, Slovakia, Slovenia, Monaco.

It is understood that no delivery can be made to hotels or to PO boxes.

The delivery of the articles will intervene, after the payment of the amount of the order will have been recorded, to the address of the Customer or of the natural person designated by the Customer, within the period indicated to

the Customer before placing the order. In the absence of an indication of the delivery date, and in accordance with the provisions of article L216-1 of the Consumer Code, the delivery of the items ordered will take place no later

than 30 days from the day following the confirmation of the order, subject to full payment of the price. The KORLOFF PARIS company will deliver the items ordered either by express transport or by simple parcel.

If, upon delivery, the exterior appearance of the package is not perfect, the Customer will open it in the presence of the carrier to check the condition of the item. In case of damage to the article, the Customer will detail them

precisely on the delivery slip, and may send a complaint to the E-commerce service of KORLOFF PARIS (contact@korloff.com) in accordance with article 11 below. If the delivery of products is delayed by an event beyond the

control of KORLOFF PARIS, KORLOFF PARIS will inform the Customer as soon as possible and will make every reasonable effort to minimize the effect of this delay.

If the company KORLOFF PARIS does not deliver within the period indicated before placing an order or within thirty (30) days of the date of the order confirmation, the Customer may cancel the order in question and obtain reimbursement of the sums paid for. advance and corresponding to any product not received if, after having instructed KORLOFF PARIS in writing to make delivery within a reasonable additional period, KORLOFF PARIS has not performed. In any event, the only recourse in the event of failure by KORLOFF PARIS to deliver the order will be for the Customer the right to cancel the order concerned and to receive a refund of the sums paid in advance and corresponding to any product not received. It should be noted that the shipment of the items ordered is always subject to receipt of full payment from the Customer.

KORLOFF PARIS will need a handwritten or electronic signature from the Client or that of a person present at the designated delivery address to confirm the delivery of each product. If the Customer has designated a recipient who is not himself for delivery purposes (for example, in the case of a gift), he understands and accepts that proof of the recipient's signature constitutes proof of delivery and execution by the company KORLOFF PARIS of its obligation of delivery, and a transfer of responsibility and risks to the recipient as if the product had been delivered to him. KORLOFF PARIS reserves the right to deliver the products only to the person who is the intended recipient of the order, as indicated on the package label, and to request an identity check for verification purposes at time of delivery of certain product categories. Please contact our Customer Relations Department for more information.

• Collection of your package in store - Click and Collect

When removing the item from the store, you must present the order confirmation email as well as a valid identity document. Your identity will then be verified, which you expressly accept by choosing this delivery method. The shop also reserves the right to check the payment card used for the payment of his order. The purchased item will then be returned to the Customer against signature of a withdrawal slip.

You also have the possibility of asking a person of your choice to come and pick up the article for you and on your behalf under the conditions of this article. This third person will be asked to bring:

- his own ID,

- your ID,

- your letter signed by you authorizing this person to come and collect the property in your name and on your behalf,

- the e-mail for the provision of the item in store that you have received.

The store may collect the main information from the identity documents in order to ensure your security and to prevent any fraudulent use of your identity and / or your means of payment.

This service is offered and available in our Parisian store located at 20 rue de la paix, 75002 Paris.

• Tracking control

Whatever delivery method you choose, KORLOFF PARIS will notify you by email of the progress of your order. You can also follow the progress of your order by email or by contacting our Korloff Paris advisers on 01 49 27 92 09 The delivery time for personalized products is 12 weeks. All our products are sent in a Korloff Paris box.

ARTICLE 8: SATISFIED OR REIMBURSED

- right of withdrawal and return of items. The company KORLOFF PARIS intends that those of these Customers who are not satisfied with the items ordered can exercise the right of withdrawal provided for in article L221-18 of the Consumer Code under the best conditions. The Customer has a period of fourteen (14) days from receipt of the articles to exercise his right of withdrawal without having to justify reasons or pay penalties, for reimbursement purposes. Before the expiration of this period, the Customer must send KORLOFF PARIS a declaration of withdrawal by post or by e-mail, using the withdrawal form available in Annex II of the GTC or any other unambiguous declaration expressing the will to retract. The Customer can use the model withdrawal form but it is not mandatory. Therefore, the Customer must return the items within a maximum of fourteen (14) days following the date of withdrawal, in their original packaging, in their original (new) condition, complete (accessories, instructions ... ), accompanied by the return slip (provided by a simple email to contact@korloff.com) carefully completed, at the following address: KORLOFF PARIS, E-commerce Service, 20 rue de la Paix, 75002 PARIS.

It will be up to the Customer to provide proof of this return, which implies that the items must be returned by registered mail, or by any other means giving a certain date, the risks of return remaining borne by the Customer. On a commercial basis, KORLOFF PARIS agrees to bear the return delivery costs.

The reimbursement of items returned at the invoiced price will be made, according to the method of payment of the items, by credit to the Customer's bank account corresponding to the bank card used for payment, within fourteen (14) days of receipt, by KORLOFF PARIS, returned items. It is specified that within the framework of the use of the Gift Service, the right of withdrawal remains for the exclusive benefit of the Customer and can in no case be exercised by the recipient of the gift.

Items returned incomplete, damaged, damaged, deteriorated or soiled by the Customer will not be refunded. The right of withdrawal does not apply to articles made according to the Customer's specifications, such as products made to measure, or clearly personalized.

ARTICLE 9: EXCHANGE

The KORLOFF PARIS company wishes to offer its Customers the possibility of exchanging the items delivered under the conditions described below.

It is specified that within the framework of the use of the Gift Service, the faculty of exchange cannot be exercised by the recipient of the gift but only by the Customer.

The Customer may, at his option, within thirty days of the delivery date:

- Or proceed to the remote exchange. In this case, the Customer must return the items delivered in their original packaging, in their original condition (new), complete (accessories, instructions ...) and accompanied by the carefully completed return slip, to the address following: KORLOFF PARIS Service E-boutique, 20 rue de la Paix, Paris.

It will be up to the Customer to provide proof of this return, which implies that the items must be returned by registered mail, or by any other means giving a certain date, the risks of return remaining the responsibility of the Customer. On a commercial basis, the return costs will be borne by KORLOFF PARIS. Any new delivery can only take place as from the reception by the company KORLOFF PARIS of the articles returned by the Customer.

- Or go to one of the stores belonging to the KORLOFF PARIS company established in mainland France with the items delivered in their original packaging, in their original (new) condition, complete (accessories, instructions ... ) and accompanied by a copy of the invoice in order to proceed with the exchange. Whichever option you choose, items returned incomplete, spoiled, damaged, deteriorated or soiled by the Customer will not be exchangeable.

In case of exchange of articles, the initial sale will be resolved. The payment of the new sale will be made by compensation with the amount of the previous sale, it being understood that any overpayment will be the subject either of a credit in favor of the Customer, or of a re-credit on the bank card of the Client or on the Client's bank account provided that the Client resumes contact with the Client Relations Department.

In the event of an article exchange via the Customer Relations Service (remote exchange), the new sale will be subject to these general conditions of sale. In case of an exchange in store,

the new sale will be subject to the general conditions of sale applicable in the event of a store sale.

ARTICLE 10: CONFORMITY - WARRANTY

The Customer must ensure that the items delivered to him correspond to his order. In the event that the items delivered do not comply with his order, the Customer must inform the Client Relations Service of the company KORLOFF PARIS by telephone and return the items in question according to the return rules set out in section 8 hereof general conditions of sale and below (return costs).

KORLOFF PARIS items are subject to the warranty conditions provided by law.

Thus, the Customer benefits from the legal guarantee of conformity, for defective, damaged or damaged products and not corresponding to the order, and from the legal guarantee of hidden defects, arising from a defect in material, design or manufacturing. affecting the products sold.

The Customer is informed that the guarantor of the defects of the thing sold is the company KORLOFF PARIS. When acting as a legal guarantee of conformity, the Customer:

• Has a period of two (2) years from the delivery of the goods to act;

• May choose between repairing or replacing the goods, subject to the cost conditions provided for in article L.217-9 of the Consumer Code;

• It is exempt from providing proof of the existence of the lack of conformity of the goods during the twenty-four (24) months following the delivery of the goods, except for second-hand goods.

The legal guarantee of conformity applies regardless of the commercial guarantee that may be granted. The Customer may decide to implement the guarantee against latent defects within the meaning of article 1641 of the civil code. In this case, the Customer can choose to cancel the sale or reduce the price in accordance with article 1644 of the Civil Code.

When the Customer benefits from the legal guarantee of conformity or the legal guarantee of hidden defects, the delivery costs will be reimbursed on the basis of the price invoiced by the company KORLOFF SA and the return costs will be reimbursed upon presentation of supporting documents.

The legal provisions relating to the guarantee of conformity and the guarantee of hidden defects are reproduced in Annex I to these GTC.

ARTICLE 11: COMPLAINTS – INFORMATION

For any information, complaint or question relating to the conditions of Internet sales put in place by the company KORLOFF PARIS or to the articles themselves, Customers must contact the E-commerce Service by email: contact@korloff.com if necessary, recalling their order number.

Article 12: PERSONAL DATA

The company KORLOFF PARIS collects and processes personal data from the Client in accordance with its policy relating to cookies and the protection of personal data, accessible on the Site www.korloff.com.

ARTICLE 13: INTELLECTUAL PROPERTY RIGHTS

The KORLOFF PARIS brand, as well as all figurative or non-figurative brands and more generally all the illustrations, images and logotypes appearing on the Site and / or KORLOFF PARIS items, their accessories or their packaging, whether or not they are registered , are and will remain the exclusive property of KORLOFF PARIS. Any total or partial reproduction, modification or use of these brands, illustrations, images and logotypes, for any reason and on any medium whatsoever, without the express prior agreement of KORLOFF PARIS, is strictly prohibited. It is the same for any combination or conjunction with any other brand, symbol, logotype and more generally any distinctive sign intended to form a composite logo. It is the same for all copyrights, designs and models, patents relating to articles which are the property of KORLOFF PARIS.

ARTICLE 14: FORCE MAJEURE

The performance by the company KORLOFF PARIS of all or part of its obligations will be suspended in the event of the occurrence of a case of force majeure which would hinder or delay its execution. Are considered as such, in particular, without this list being exhaustive, war, riots, insurrection, administrative police measures, social unrest and strikes for a reason external to the company.

The company KORLOFF PARIS will inform the Customer of the occurrence of a case of force majeure as soon as possible. In the event that this suspension continues beyond a period of fifteen days following the information communicated to the Customer, the latter will then be able to terminate the order in progress, and a refund will then be made under the conditions set out in article 8 of these general conditions of sale.

ARTICLE 15: DISPUTES - APPLICABLE LAW

These general conditions of sale are subject to French law. In case of difficulty arising from the order or delivery of KORLOFF PARIS items, the Customer will have the opportunity, before any legal action, to seek an amicable solution, in particular with the help of a consumer association or any other advice of his choice.

Any litigation likely to result from the interpretation or the execution of the present general conditions of sale and its continuations will be subjected to the exclusive competence of the French courts.

The Customer is informed that he can, in any event, submit the dispute relating to these CGV opposing him to KORLOFF PARIS at the MEDICYS Mediation and Cyber-Services Center (https://medicys-consommation.fr/) who will try, in complete independence and impartiality, to bring the parties together in order to reach an amicable solution. In this context, you must first send a written complaint to MEDICYS - 73, Boulevard de Clichy 75009 Paris. A month later, if you do not obtain satisfaction, you can contact the MEDICYS mediation service simply and free of charge by electronic means by submitting your file on www.medicys-consommation.fr, or by simple mail (attach your email, your telephone and written complaint) to MEDICYS - 73, Boulevard de Clichy 75009 Paris.

Annex I: PROVISIONS RELATING TO GUARANTEES

• Article L 217-4 of the Consumer Code

“The seller delivers goods that comply with the contract and is liable for any lack of conformity existing at the time of delivery.

He is also responsible for any lack of conformity resulting from the packaging, the assembly instructions or the installation when the latter has been charged to him by the contract or has been carried out under his responsibility. "

• Article L 217-5 of the Consumer Code

"The goods comply with the contract:

1 ° If it is suitable for the use normally expected of similar goods and, if applicable:

- if it corresponds to the description given by the seller and has the qualities that the latter presented to the buyer in the form of a sample or model;

- if it has the qualities that a buyer can legitimately expect in view of the public statements made by the seller, by the producer or by its representative, in particular in advertising or labeling;

2 ° Or if it has the characteristics defined by mutual agreement by the parties or is suitable for any special use sought by the buyer, brought to the attention of the seller and which the latter has accepted. "

 Article L 217-7 of the Consumer Code

“The lack of conformity which appears within a period of twenty-four months from the delivery of the goods is presumed to exist at the time of delivery, unless proven otherwise.

For second-hand goods sold, this period is fixed at six months. The seller can combat this presumption if it is not compatible with the nature of the goods or the alleged lack of conformity. "

• Article L 217-8 of the Consumer Code

“The buyer is entitled to demand that the goods conform to the contract. However, he cannot challenge compliance by invoking a defect that he knew or could not ignore when he contracted. The same applies when the defect has its origin in the materials which he himself supplied."

• Article L 217-9 of the Consumer Code

“In the event of a lack of conformity, the buyer chooses between repairing and replacing the goods.However, the seller may not proceed according to the choice of the buyer if this choice involves a manifestly disproportionate cost with regard to the other modality, taking into account the value of the good or the importance of the defect. He is then required to proceed, unless this is impossible, according to the method not chosen by the buyer. "

• Article 217-10 of the Consumer Code

“If the repair and replacement of the goods are impossible, the buyer can return the goods and have the price returned or keep the goods and get part of the price. The same faculty is open to him:

1 ° If the solution requested, proposed or agreed in application of article L. 217-9 cannot be implemented within one month following the buyer's complaint;

2 ° Or if this solution cannot be without major inconvenience for him given the nature of the good and the use he seeks.

The cancellation of the sale cannot however be pronounced if the lack of conformity is minor.”

 Article L 217-12 of the Consumer Code

“The action resulting from the lack of conformity lapses two years after delivery of the goods.”

• Article L.217-16 of the Consumer Code

"When the buyer requests from the seller, during the course of the commercial guarantee granted to him during the acquisition or repair of movable property, a repair covered by the guarantee, any period of immobilization at least seven days is added to the duration of the remaining warranty. This period runs from the buyer's intervention request or the provision for repair of the goods in question, if this provision is subsequent to the intervention request. "

• Article 1641 of the Civil Code

"The seller is bound by the guarantee for hidden defects in the thing sold which makes it unfit for the use for which it is intended, or which reduces such use so much, that the buyer would not have acquired it, or n 'would have given them a lower price, if he had known them. "

• Article 1642 of the Civil Code

"The seller is not liable for apparent defects which the buyer was able to convince himself of”.

• Article 1648 paragraph 1 of the Civil Code

"The action resulting from latent defects must be brought by the purchaser within two years of the discovery of the defect. "

Annex II: MODEL WITHDRAWAL FORM

This form must be completed and returned only if the Customer wishes to withdraw from the order placed on the Site "www.korloff.com" except exclusions or limits to the exercise of the right of withdrawal according to the applicable general conditions of sale.

For the attention of KORLOFF PARIS:

E-commerce service,

20 rue de la Paix

75002 PARIS

contact@korloff.com

I hereby notify you of my withdrawal from the contract relating to the order below:

• Date of the order :

• Order number:

• Client name :

• Customer address:

Signature of the Client (only in case of notification of this form on paper):

Date: