Model form for withdrawal from a distance contract

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

– Kam:

LITIDEAL UAB

Company code: 111444388

Address: Laisvės pr. 3, Vilnius, Lithuania

E-mail: avisnow@avis.lt

– I/We* hereby give notice that I/We* withdraw from the Service Contract for the MyAvis Car Rental Service Contract*,

– Ordered*/obtained* [data],

– Name of user(s),

– Address of the user(s),

– Signature(s) of the user(s), (if applicable)

– Date.

(*) Delete what is not required