Model Withdrawal Form
Service preview: purchases, eSIM delivery and electronic support are not enabled. Service terms describe the intended offering and will be reviewed before commercial launch. No regulatory authorisation or VAT status is asserted.
Use this form only if you wish to withdraw from a contract where a right of withdrawal is available. You do not have to use this form if you otherwise send us an unequivocal statement of withdrawal.
To: BELL UGT LTD Alexandreias 2-4, Bridge Tower, Flat/Office 3A, 3013 Limassol, Cyprus Contact: our contact details
I/We hereby give notice that I/We withdraw from my/our contract for the following eSIM service:
Order number: ______________________________________
Plan / destination: __________________________________
Date ordered: _______________________________________
Name of consumer(s): ________________________________
Email used for order: ________________________________
Address of consumer(s), if required: ________________________________________________________
Signature of consumer(s), only if submitted on paper: ________________________________________________________
Date: ______________________________________________
If the eSIM has already been installed, activated or used, please state this so that we can assess the request correctly under the applicable withdrawal and digital-service rules:
________________________________________________________