Please complete and return this form only if you wish to withdraw from the contract.

To the attention of

Art et Communautés RAIZS

17 bis quai Gambetta 91260 JUVISY-SUR-ORGE - France (metropolitaine)

I notify you hereby my withdrawal from the contract for the sale of the property below:

Signature (of) consumer (s) (only if notification of this form on paper):

Send the letter by registered letter with acknowledgment of receipt.