(Fill in this Form and send it back only if you want to withdraw from the contract. The Form has to be printed, signed and sent scanned to the e-mail address below and/or attached to the shipment with returned goods). 

AddresseeCCF s.r.o., Santražiny 575, 760 01 Zlín


E-Shop: Mumijo.cz

Company: CCF s.r.o.

Address for sending: Santražiny 575, 760 01 Zlín

Company ID/VAT No.: IČ 26890771, DIČ CZ26890771

E-mail address: info@mumijo.cz 

Phone number: +420 571 623 624   


I declare that I hereby withdraw from the purchase contract of the following goods:

  • Date of ordering:
  • Order number:
  • The funds for ordering and/or even for delivery, have been sent in the manner
    and will be returned in the manner (in case of transfer to the account, please send the account number)
  • Name and surname of the consumer:
  • Consumer address:
  • E-mail:
  • Tel.: 


In (fill-in the place here)on (fill-in the date here)



Name and surname of the consumer