General terms and conditions of sale

General Terms and Conditions of Sale (GTC)

Last updated: 17/09/2025

Welcome to the website of Hasna TIJANI, sole proprietor. We are delighted to welcome you and hope you enjoy our products.

Your satisfaction is our priority and we make every effort to offer you the best customer experience.

We ask you to carefully read the following terms and conditions of sale before accepting them.

The Terms and Conditions are important for both Us and You!

The purpose of this document is to inform you, prior to your purchase, about our terms of sale and to answer any questions you may legitimately have, such as "can I cancel?", "what are the delivery times?",…

WHO ARE WE ?

Hasna TIJANI, individual entrepreneur

SIRET: 90480618900018

VAT number: FR67904806189

Bobigny Trade and Companies Register

ateliercygnature.com

ateliercygnature@gmail.com

Designated herein as Hasna TIJANI, sole proprietor

Here are some other elements of the definitions:

In the present:

The "Seller", Hasna TIJANI, sole proprietor

· , “We”; designate the professional seller.

· “You”, the “Client(s)”; referring to the non-professional buyer having the status of consumer.

The “Site” refers to all pages of the Seller’s website accessible via the link Editionprojetnoor@gmail.com

• The “Terms and Conditions”; refer to these general terms and conditions of sale

APPLICATION OF THE TERMS AND CONDITIONS:

The General Terms and Conditions govern and apply to all sales of Seller's products made on the Site to Customers.

The General Terms and Conditions of Sale prevail over all other conditions or contradictory documents present on the Seller's Site or its social networks and/or in physical stores; except for specific derogation conditions agreed between the Parties.

The Terms and Conditions are permanently accessible on the Website, and we provide a link to them before you place your order. You have the option to download and/or print them to keep a copy.

The terms and conditions are subject to change; modifications are not retroactive, and only those in effect on the date of your order apply to you.

Accepting the Terms and Conditions by ticking the box provided for this purpose and validating this choice by clicking implies your full and complete adherence to and acceptance of the Terms and Conditions.

By placing an order online, you are entering into a contract with the Seller. Therefore, you must and acknowledge that you are of legal age and have the legal capacity to enter into this contract.

The invalidity of a contractual clause does not render the general terms and conditions invalid, and the headings are without value.

Even if the Seller does not at any time enforce one of the clauses of these general terms and conditions of sale, or the Customer's failure to fulfill its obligations as described herein, the Seller does not in any way waive its right to enforce these conditions or obligations in the future.

WHAT PRODUCTS DO YOU OFFER?

You will find our products offered for sale by the Seller on the Site.

The essential characteristics of the products offered by the Seller are presented in the product descriptions for each item. You will find substantial information about the product there before making any purchase.

Photographs accompany the product descriptions so that you can visualize the product; however, minor variations in the representation of the products are possible with photographs, which does not engage the responsibility of the Seller.

You will receive pre-contractual information prior to the conclusion of the sales contract; it is your responsibility to consult this information before placing any order.

This information is provided in French, and the Seller strives to present it clearly, legibly, and understandably. It is important to note that unless the information is substantial, the Seller cannot be held liable for any errors, omissions, or misunderstandings on the part of the Customer.

Availability

Our products are offered as long as they are visible on the Site and while stocks last. If a product is unavailable after you place your order, we will inform you by email and you will have the option to:

· Choose an equivalent product at the same price as a replacement.

OR

• Obtain a credit note corresponding to the amount of the out-of-stock product, valid for 1 year on the entire Site; delivery costs will be refunded without delay if the order consists solely of the out-of-stock product.

OR

• Obtain a refund for the unavailable product.

The refund will be processed no later than 14 days after your refund request. The Seller will issue the refund using the same payment method used for the initial purchase. The Seller is not liable for any cancellation compensation unless the breach of contract is directly attributable to them.

HOW TO PLACE AN ORDER?

Any order placement implies payment by the Customer; it is an order with an obligation to pay.

The ordering process is carried out in several stages:

1. Viewing the products offered for sale by the Seller on the Site

2. Customer selection of product(s) and addition to cart

3. The Customer views the order details and its total price

4. The Customer enters the requested information on the order page

5. Correction of any errors by the Client

6. Order confirmation by the Customer, which expresses their acceptance of the order. At this stage, the Customer expressly and unreservedly accepts the General Terms and Conditions of Sale

7. The Client provides their bank details

8. Order validation and payment by the Customer

9. Order acknowledgement by the Seller, who sends a confirmation email to the Customer after receiving full payment for the order

At this stage, the order cannot be modified, except with the Seller's express and exceptional agreement; and cannot be cancelled except in the case of the right of withdrawal, the conditions of which are defined below, or in cases of force majeure. Unless proven otherwise, the data recorded in the Seller's computer system constitutes proof of all transactions concluded with the Customer.

WHAT ARE THE PRICING CONDITIONS?

Any order placement implies payment by the Customer; it is an order with an obligation to pay.

Price

Product prices are displayed on the Site; on the product description pages and on the order summary page, before you confirm your order.

Prices are expressed in euros (€) and VAT is not applicable. (VAT not applicable, Art. 293 B of the French General Tax Code).

The price may be changed at any time by the Seller. However, the price applicable to you is the one displayed on the Site at the time of your order.

You will be able to benefit from the discounts (promotion, sale, etc.) that appear on the Site under the conditions and during the period of validity specified on the Site.

Unless otherwise agreed upon by the Seller, delivery and shipping costs are not included. They are charged separately and displayed before the order is placed.

The Seller reserves the right to suspend or cancel the order in the event of non-compliance with the submitted payment conditions.

You will receive your invoice at the email address you provide. Customers who created an account when placing their order can access their invoice in their personal account.

Please note that orders shipped outside the European Union and/or French overseas departments and territories are subject to customs formalities.

The payment of customs duties and any other import taxes is the responsibility and at the expense of the Client.

Payment

Payment is made immediately after order confirmation.

Payment is due in full and payable using the following payment methods:

Shopify and Paypal payment options available.

WHAT ARE THE DELIVERY CONDITIONS?

Delivery

Delivery means the transfer to the Customer of physical possession or control of the goods.

We offer our products for sale in France and Europe.

The Seller will deliver the products according to the terms defined during the order (price and carrier), to the address that you provided when placing your order and within the time frame indicated during the order.

You must be vigilant and check the address provided before validating your order, as you will be held solely responsible for the consequences arising from your input error and the related costs, including reshipping costs which will be your exclusive responsibility.

Deadline

The Seller will make every effort to ensure that your order is shipped within the timeframe indicated when the order was placed.

Delivery times begin from the date of dispatch. This timeframe does not include order preparation time, which is 4 to 5 days.

You may request in writing the cancellation of the sale (under the conditions set out in Articles L 216-2 et seq. of the French Consumer Code) only if the delivery delay exceeds 30 days from the order date. The Seller will then be required to refund the sums paid no later than fourteen days following the date of cancellation, without any compensation or deductions.

The cancellation of the sale will not be accepted if the delay or failure to deliver occurs due to the Client or a case of force majeure.

Price

The delivery price varies depending on the carrier chosen and the weight of the package.

In any case, the delivery time and price will be communicated to you before your order is validated.

I'M HAVING A PROBLEM WITH MY ORDER…

Why was my order cancelled?

We may cancel your order for any legitimate reason, including in the event of a prior dispute.

The order may also be refused in the event that the quantities ordered are abnormally high compared to the quantities usually ordered by purchasing Clients as consumers.

It is possible that we may cancel your order if a product is unavailable (see article "WHAT PRODUCTS DO YOU OFFER?" in the Terms and Conditions).

My package is damaged, what should I do?

The Seller retains ownership of the delivered goods from the day of delivery until full payment of the entire sale price by the Customer.

The transfer of risk of loss and damage to the products occurs upon actual delivery of the order.

Upon delivery, you must ensure that the package is in good condition and undamaged. If you notice any damage to your package upon receipt, please refuse delivery and follow the procedure below:

Clearly state your reservations on the delivery note or on the package itself, if applicable (e.g., package torn at the top, 5 cm hole / wet package, open package, etc.). Please note that simply checking the "with reservation" box has no legal value. You must write down your reservations precisely; it is advisable to take photos of the package as evidence. If the delivery driver/carrier does not allow you time to check the condition of the package, please add this to your reservations.

Within three business days of delivery, send the carrier a registered letter with acknowledgment of receipt to inform them of any apparent damage and confirm your reservations. Please note that if the delivery person/carrier does not allow you to check the condition of the package, this period is extended to 10 days. The same procedure must be followed if the damage (breakage, theft) was only discovered upon opening the package, even if the exterior of the packaging is undamaged.

In parallel, please contact the Seller immediately (see "HOW TO CONTACT YOU?") to report the problem.

To process your request more quickly, please provide us with the following photos: order number, delivery note + photo of the products.

In the event that you choose to be delivered by a carrier other than the one chosen and offered by the Seller, the transfer of risk occurs as soon as the products are handed over to the carrier, therefore, the Seller declines all responsibility and any loss or damage to the products will be at your expense.

My package seems to be lost, what should I do?

In case of lost parcel, please contact the Seller without delay (see "HOW DO YOU CONTACT US?").

I received a defective product, what should I do?

Upon delivery, you have three (3) working days to submit your complaint in writing (by post or email).

You must include all supporting documents with your request, including photos proving the reason for your complaint. If the complaint is not submitted within these time limits and under these conditions, it will be rejected by the Seller and the products will be deemed compliant and free from any apparent defects.

You may claim a refund or replacement of the product, which will be at the Seller's expense, for any delivered product whose non-conformity or apparent or hidden defects have been duly proven by the Customer under the conditions provided for in Articles L 217-4 et seq. of the Consumer Code and those provided for in these General Terms and Conditions.

CAN I WITHDRAW?

You have the right to go back!

For non-personalized products:

Yes, but there are conditions to be met if you wish to withdraw:

From the day you receive your order, you have 14 clear days to inform the Seller of your intention to withdraw, without having to justify your decision or bear any costs other than those necessary to return your order.

To do this, you can use the withdrawal form which you will find in the appendix at the bottom of the Terms and Conditions page.

You can also express your wish to withdraw, in writing, unambiguously, by post or email, specifying:

Your order number

• The reference number of the item being returned

Your first and last name

Your address

Your phone number

Your email address

In the event of a dispute, it is up to you to prove that you have complied with the aforementioned withdrawal period.

Exception to the right of withdrawal

• For products that are personalized

The right of withdrawal is exclusive for orders of products that are personalized.

In the event of a specific request from the Client (custom-made / alterations etc.), the right of withdrawal is also excluded.

The right of withdrawal is indeed conditional upon compliance with the requirements set out in Article L 221-28 of the Consumer Code, which stipulates in particular that "the right of withdrawal may not be exercised for contracts:

1° For the provision of services fully performed before the end of the withdrawal period and, if the contract subjects the consumer to an obligation to pay, the performance of which has begun with his prior and express agreement and with his acknowledgment of the loss of his right of withdrawal, when the service has been fully performed by the professional;

2° Supply of goods or services whose price depends on fluctuations in the financial market which are beyond the control of the professional and which may occur during the withdrawal period;

3° Supply of goods made to the consumer's specifications or clearly personalized;

4° Supply of goods liable to deteriorate or expire rapidly;

5° Supply of goods which have been unsealed by the consumer after delivery and which cannot be returned for reasons of hygiene or health protection;

6° Supplies of goods which, after delivery, are by their nature inseparably mixed with other articles;

7° Supply of alcoholic beverages whose delivery is deferred beyond thirty days and whose value agreed upon at the conclusion of the contract depends on market fluctuations beyond the control of the professional;

8° Maintenance or repair work to be carried out urgently at the consumer's home and expressly requested by him, within the limit of spare parts and work strictly necessary to respond to the emergency;

9° The supply of audio or video recordings or computer software which have been unsealed by the consumer after delivery;

10° Supply of a newspaper, periodical or magazine, except for subscription contracts to these publications;

11° Conclusion during a public auction;

12° Provision of accommodation services, other than residential accommodation, transport services for goods, car rentals, catering or leisure activities which must be provided on a specific date or during a specific period;

13° For the supply of digital content without tangible support where performance has begun before the end of the withdrawal period and, if the contract subjects the consumer to an obligation to pay, where: a) He has given prior express consent for the performance of the contract to begin before the expiry of the withdrawal period; and b) He has acknowledged that he will lose his right of withdrawal; and c) The trader has provided confirmation of the consumer’s agreement in accordance with the provisions of the second paragraph of Article L.221-13.

HOW TO MAKE A RETURN?

Please note, this only applies to products not excluded from the right of withdrawal.

The return must comply with the following conditions:

· The products must be returned to the Seller no later than 14 days after you have notified the Seller of your intention to withdraw.

· Products must be returned in their original and complete condition (without risk of the possibility of unpacking and testing the product) allowing them to be put back on the market in new condition.

• The products must not be damaged or incomplete.

· The products must not have any body odor, perfume odor or laundry detergent odor.

We will contact you by email for the return address: ateliercygnature@gmail.com

Unfortunately, online shopping doesn't allow you to inspect the product as you would in a physical store. However, the right of withdrawal (subject to the actual conditions) allows you to try the product as you would in a physical store. It's important to note that if the seller observes signs of use beyond what is permitted, or any general depreciation of the product, the seller may apply a discount, and you will only be refunded the amount of your order, less the discount.

When the conditions set forth herein are met, the Seller will reimburse you within a maximum of 14 days after you have informed them of your intention to withdraw. However, the Seller reserves the right to defer reimbursement until the returned items have been received.

The Seller will issue the refund using the same payment method used for the initial purchase. You will receive a full refund, excluding delivery charges.

Furthermore, the costs and risks associated with the return are your responsibility. *To ensure efficient processing of your return, we recommend using the Colissimo tracked shipping service and keeping all proof of shipment, including shipping receipts and the package tracking number. This will allow you to locate the package should any issues arise.

Please note that only the sender (i.e., you as the customer) is authorized to initiate an investigation with the postal service in case of a delivery problem. It is important to emphasize that the seller cannot be held liable for any loss or damage during the return process.

In the event of a dispute or refund request, you are responsible for providing proof that you complied with the withdrawal period. Thank you for your understanding and cooperation.

In accordance with articles L.616-1 and R.616-1
In accordance with the Consumer Code, our company has implemented a consumer mediation system. The designated mediation entity is:

CONSUMER MEDIATION DEVELOPMENT/MED CONSUMER DEVELOPMENT

In case of a dispute, you can file your complaint on their website: https://www.medconsodev.eu

or by post by writing to:

CONSUMER MEDIATION DEVELOPMENT/MED CONSUMER DEVELOPMENT
Centre d'Affaires Stéphanois SAS
L'HORIZON BUILDING – ESPLANADE DE FRANCE
3, RUE J. CONSTANT MILLERET – 42000 SAINT-ÉTIENNE

HOW TO CONTACT YOU?

For all inquiries or complaints, whether before or after your purchase, you can contact customer service by email: ateliercygnature@gmail.com

REFERENCE CLIENT

Your feedback, messages, and photos are welcome! They are essential to help the Seller continuously improve and provide you with a quality customer experience.

By agreeing to these Terms and Conditions, you authorize the Seller to make them public on its Website and/or social media platforms such as Instagram, TikTok, Snapchat…

Unless expressly prohibited by the Client, the Seller is authorized to remove the Client's first name and/or username (social networks) from its reference lists.

When the Customer sends the Seller a message, comment, and/or feedback regarding their order, they authorize the Seller to use this feedback for promotional and advertising purposes. The Customer authorizes the Seller to adapt the format of this feedback or to make changes to its form.

This license to use is granted free of charge and without compensation; for the legal term of copyright protection and for the whole world.

PERSONALIZATION: DISCLAIMER

The Client agrees to choose and provide text that:

• Does not infringe upon the rights of third parties (intellectual property rights, trademarks, etc.)

· Is not contrary to public morals, defamatory or of a nature to infringe upon human dignity

Furthermore, please note that the Seller does not check the spelling or grammar of the text you provide. Therefore, the Seller cannot be held responsible for any errors or typos on your part. You are solely responsible for the content of the text you personalize.

Customizing items

After choosing their product, the Customer can proceed with customization by following the automated process available on the website, which includes:

1. Entering the text of your choice in the tab provided for this purpose, up to a limit of [X] characters;
2. Selecting the font from those offered on the site;
3. Choosing the thread color from the available options.

The Customer agrees to provide accurate and complete information for personalization. The Seller cannot be held liable for any errors or omissions resulting from the information entered by the Customer.

Due to the personalized nature of the product, any order including personalization is irreversible and cannot be refunded or exchanged, except in the case of a manufacturing defect or obvious error attributable to the Seller. In this case, the Customer must notify the Seller of the defect within [X days] of receiving the product, along with appropriate supporting documentation.

The Customer is advised to carefully check all information entered before validating the order in order to ensure the conformity of the desired personalization.

LIMITATION OF LIABILITY OF THE SERVICE PROVIDER

We are committed to serving you in the best possible way; however, the Service Provider cannot be held liable in the event of:

Content provided by the Client: The Client acknowledges and accepts that the Service Provider does not check the spelling or grammar of the text, nor any other element provided by the Client. Consequently, the Service Provider cannot be held liable for any errors or typos contained in the content submitted by the Client. The Client assumes full responsibility for the content and texts they provide.

The Client agrees to provide content and/or texts that comply with the following conditions:

• Respect for third-party rights: The content must not infringe upon the intellectual property rights of third parties, including but not limited to copyrights, trademarks, or other intellectual property rights. The Client is fully responsible for the elements provided (images, photographs, texts, etc.) and must hold the necessary rights for their use. The Client shall indemnify the Service Provider against any third-party claims relating to these elements.
• Compliance with good morals: the content must not be defamatory, obscene, contrary to good morals, or of a nature to infringe upon human dignity.

WITHDRAWAL

Exception to the right of withdrawal:

Article L 221-28 of the Consumer Code stipulates that:

"The right of withdrawal cannot be exercised for contracts:"

1° For the provision of services fully performed before the end of the withdrawal period and, if the contract subjects the consumer to an obligation to pay, the performance of which has begun with his prior and express agreement and with his acknowledgment of the loss of his right of withdrawal, when the service has been fully performed by the professional;

2° Supply of goods or services whose price depends on fluctuations in the financial market which are beyond the control of the professional and which may occur during the withdrawal period;

3° Supply of goods made to the consumer's specifications or clearly personalized;

4° Supply of goods liable to deteriorate or expire rapidly;

5. The supply of goods which have been unsealed by the consumer after delivery and which cannot be returned

6° Supplies of goods which, after delivery, are by their nature inseparably mixed with other articles;

7° Supply of alcoholic beverages whose delivery is deferred beyond thirty days and whose value agreed upon at the conclusion of the contract depends on market fluctuations beyond the control of the professional;

8° Maintenance or repair work to be carried out urgently at the consumer's home and expressly requested by him, within the limit of spare parts and work strictly necessary to respond to the emergency;

9° The supply of audio or video recordings or computer software which have been unsealed by the consumer after delivery;

10° Supply of a newspaper, periodical or magazine, except for subscription contracts for these publications;

11° Conclusion during a public auction;

12° Provision of accommodation services, other than residential accommodation, transport services for goods, car rentals, catering or leisure activities which must be provided on a specific date or during a specific period;

13° The supply of digital content without tangible medium where performance has begun before the end of the withdrawal period and, if the contract subjects the consumer to an obligation to pay, where:

a) He has given his prior express consent for the performance of the contract to begin before the expiry of the withdrawal period; and

b) He acknowledged that he would lose his right of withdrawal; and

c) The professional has provided confirmation of the consumer's agreement in accordance with the provisions of the second paragraph of Article L. 221-13.

WARNING: IT IS NOT POSSIBLE TO WITHDRAW:

• Personalized and/or custom-made goods

The right of withdrawal does not apply to orders for products made to measure or personalized according to the customer's specifications. Therefore, these products cannot be returned or refunded under the right of withdrawal.

LEGAL PROVISIONS

Opting out of telephone solicitation:

As a consumer customer, you can register for free on the telephone marketing opt-out list on the website www.bloctel.gouv.fr if you do not wish to be contacted for commercial purposes by telephone.

Compliance and legal guarantee:

The Customer benefits from the legal guarantee of conformity (articles L. 217-3 to L. 217-20 of the Consumer Code) and the legal guarantee relating to defects in the thing sold (articles 1641 to 1648 and 2232 of the Civil Code).

Warranty against hidden defects:

Article 1641 of the Civil Code:

The seller is bound by the warranty because of hidden defects in the thing sold which make it unfit for the use for which it is intended, or which diminish this use to such an extent that the buyer would not have acquired it, or would have given only a lower price, if he had known of them.

Article 1648, paragraph one 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.

In the case provided for in Article 1642-1 , the action must be brought, under penalty of forfeiture, within one year of the date on which the seller can be discharged from the apparent defects or non-conformities.

pupil :

When you place an order, the Seller collects the personal data necessary for the conclusion of the contract, in order to guarantee its execution, to manage administrative aspects and to issue invoices.

This data includes your first and last name, postal address, email address and telephone number.

The Seller guarantees that this data collection is carried out in full compliance with applicable laws (law 78-17 of 6 January 1978 amended by law no. 2018-493 of 20 June 2018) and is based, among other things, on the following legal basis: the performance of the contract.

The Seller undertakes to use your data only within the framework of the purposes specified in the privacy policy present on the Site, unless the law requires it to be shared with a competent judicial or administrative authority.

Your data is processed internally and the Seller may communicate this data to its potential subcontractors responsible in particular for the execution, processing, management and payment of orders.

Your data will be kept for the duration of the contract or for up to 3 years after our last contact with you. After that, it will be archived in accordance with the legal requirement, i.e., 5 years.

We take security measures to protect your personal data against alteration, damage, or unauthorized access by third parties. To respond to a security incident or to address threats or vulnerabilities, we may take measures such as implementing enhanced authentication procedures, requiring customers to strengthen their passwords, etc.

You have rights to control how your data is used. You can request access to your data, have it corrected, or object to its inclusion in a file. You have a permanent right of access, modification, rectification, objection, data portability, and restriction of processing concerning your personal information. You can also object to the collection and/or use of your data as long as it is not essential for the proper performance of the contract.

To exercise this right, you must submit your request by sending an email to ateliercygnature@gmail.com

If you believe that a violation of the General Data Protection Regulation (GDPR) has occurred, you have the option of appointing an association or body listed in Article 43 ter, IV of the French Data Protection Act of 1978 to seek redress before a civil or administrative court. You also have the option of filing a complaint with the French Data Protection Authority (CNIL).

More detailed information about personal data is available in the privacy policy on the Site.

Intellectual property:

The products for sale on the Site are the property of the Seller and are protected by intellectual property law.

All elements of this Site are the property of the Seller and/or its partners and are protected by French and international intellectual property laws. Any reproduction, in whole or in part, of this content is strictly prohibited and may constitute an infringement. Images, logos, trademarks, texts, photographs, and all other elements of the Website are protected by copyright; you may be subject to legal action in the event of plagiarism, copying, theft, etc.

APPLICABLE LAW

These Terms and Conditions, as well as all purchase and sale transactions mentioned, are governed by French law.

The terms and conditions presented are written in French. If they are translated into another language, only the French version shall prevail in the event of a dispute.

We inform you that in the event of a dispute arising after your purchase on the Site, you have several options for recourse, either amicably or through legal action:

For an out-of-court appeal:

You are initially invited to contact the Seller's customer service (see article "HOW TO CONTACT YOU?") in order to reach an amicable agreement.

In the event that we are unable to reach an agreement, you have the option of resorting to conventional mediation or using any other alternative dispute resolution method.

In this regard, you can use the free mediation service provided by the mediation body whose contact details follow:

To be admissible, your referral to the mediator must take place within one year of a written complaint that you received from us, which remained unsuccessful.

As a consumer, you can contact the Online Dispute Resolution (ODR) platform accessible at the following address:

https://webgate.ec.europa.eu/odr/main/index.cfm?event=main.home.show&lng=FR

You can also contact a consumer association that will help you with your procedures or even alert the DGCCRF.

When no amicable solution can be reached, you can take legal action and the dispute will be submitted to the competent courts under the conditions of ordinary law.

For legal recourse:

You may initiate legal proceedings at your own expense. The dispute will be submitted to the competent courts under the ordinary rules of law.

APPENDIX 1: MODEL WITHDRAWAL FORM

(Please complete and return this form only if you wish to withdraw from the contract, in accordance with the conditions set out in the General Terms and Conditions)

To the Seller, please provide the postal address or email address: ateliercygnature@gmail.com

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

Order number:………..

Reference of the item being returned: …………

Customer name and surname: …….

Customer/Consumer Address ……..

Customer's telephone number ………

Customer/Consumer email address ……..

Date :

Customer signature (only if this form is submitted on paper):