Legal Notice

MARMAX, SAS with capital of €9,803
Head Office: 114 Avenue Crampel – 31400 Toulouse – France
Registered with the RCS Toulouse SIREN 833 453 442 on October 30, 2017 SIRET number 833 453 442 00059 – APE 4791B

President and Managing Director: Ms. Margaux MINGUEZ LAHANA & Mr. Maxime MINGUEZ

Director of publication & editorial of the site: Ms. Margaux MINGUEZ
LAHANA

DESIGN AND PRODUCTION OF THE SITE: Mashvp Agency - mashvp.com
The site is hosted on Shopify

Terms of Sales

These General Terms and Conditions of Sale (hereinafter the "GTC") are concluded on the one hand by the company MARMAX (hereinafter "Marmax") with a share capital of €9,803.00, whose registered office is located in Toulouse, registered in the Toulouse Trade and Companies Register under number 833 453 442, the website www.stellaetsuzie.com (hereinafter the Site) and, on the other hand, by any natural or legal person wishing to make a purchase via the Site (hereinafter "the Customer").

Article 1. Purpose
These General Terms and Conditions aim to define the contractual relations between the company Marmax and the Customer and the conditions applicable to any purchase made through the Site.

These General Terms and Conditions apply to the exclusion of all other conditions, and in particular those applicable to sales in stores or through other distribution and marketing channels.

Any use of the Site implies unreserved acceptance by the Customer of these General Terms and Conditions, which the Customer acknowledges having read prior to placing his order. In this regard, they are enforceable against him in accordance with the terms of Article 1119 of the Civil Code.

The Site allows the company Marmax to offer its products (hereinafter "the Products") in France and abroad.

Before any transaction, the Customer declares on the one hand that the purchase of Products on the Site is not directly related to his professional activity and is limited to strictly personal use and on the other hand to have full legal capacity, allowing him to commit to these General Terms and Conditions. These General Terms and Conditions govern the use of the Site and the services that may be offered there as well as any purchase made on the Site.

Marmax reserves the right to modify these T&Cs at any time, in order to comply with any new regulations or to improve the use of its site. As a result, they will be applicable as soon as they are posted online.

Article 2. Products
The Products offered are those which appear on the Site within the limit of available stocks.

Marmax reserves the right to modify the collection of Products at any time. Each Product is presented on the Site in the form of a description summarizing its main technical characteristics with the greatest possible accuracy. However, if errors or omissions may have occurred in this presentation, Marmax cannot be held liable.

The Customer is fully informed that the images, photos and colors of the Products offered for sale may not correspond to the colors under the effect of the Internet browser. The photographs are as faithful as possible but do not bind the Marmax company in any way.

The sale of the Products presented on the Site is intended for all customers residing in countries which fully authorize the entry of these products into their territory.

If one or more items ordered are no longer available, the Customer will be informed by e-mail as soon as possible of the partial or total cancellation of his order.

Article 3. Pre-contractual information
The Customer acknowledges having received, prior to placing the order and concluding the contract, in a legible and comprehensible manner, these General Terms and Conditions and all information listed in Article L. 221-5 of the Consumer Code.

Article 4. Prices
The prices appear on the Product sheets of the online catalogue and are prices in euros (€) for Europe, in pounds sterling for the United Kingdom and in dollars for the rest of the world, taking into account the value added tax (VAT) applicable on the day of the order.

All prices displayed are calculated and include the value added tax (VAT) applicable in France or that applicable in the country of delivery located in the European Union.


Any change in the VAT rate may be reflected in the price of the Products.

Any local taxes that may apply to the sale are the responsibility of the Customer.

The prices indicated do not include delivery costs, which are charged in addition to the price of the products purchased according to the total amount of the order.

Marmax reserves the right to modify its prices at any time, it being understood, however, that the price appearing in the catalog on the day of the order will be the only one applicable to the Customer.

In mainland France, for any order greater than or equal to 200 euros including tax, shipping costs are free; for any order less than 200 euros including tax, a flat rate contribution to shipping costs will be invoiced to the Customer depending on the carrier chosen by the Customer.

For all deliveries within the European Union and Switzerland, shipping costs are free for all orders over 250 euros including tax. For all orders under 250 euros, a flat rate contribution to shipping costs will be charged in the amount of 10 euros including tax.

For all deliveries to the United States, Canada, United Arab Emirates, shipping costs are free for all orders.

For all international deliveries, shipping costs are free for all orders over 300 euros including tax, for all orders below that a flat rate contribution of 20 euros excluding tax will be charged.

Outside the European Union, customs or import taxes may be added to the price of our products. These additional costs are entirely the responsibility of the customer. It is therefore the customer's responsibility to inquire about these costs with their local customs office. However, for the countries listed below, customs or import taxes are included at the time of payment: United Kingdom, Canada, United States, Guadeloupe, Reunion, Martinique, New Caledonia, Saint Barthélemy and Saint Martin.

Article 5. Order and payment terms

Before any order, the Customer must create an account on the Site. The account creation section is accessible directly from the side menu bar.

When creating an account, the Customer must complete the form provided for this purpose and provide their email address and a password and, as a subsidiary measure, a date of birth in the format DD/MM.

The Customer is solely responsible for the confidentiality of his password and will bear sole responsibility for any fraudulent use of his password.

Before finalizing his order, the Customer must provide his name, first name, postal address and a telephone number, this information being mandatory for the processing and delivery of orders and the establishment of invoices.

In accordance with the law of January 6, 1978, the Customer has a right to access, modify, rectify and delete data concerning him, which he can exercise in writing to Customer Service at the address contact@stellaetsuzie.com.

If the Customer is already registered, he will fill in his username and password to identify himself.

Marmax offers the Customer the option of ordering and paying for their products in several stages:
1. the Customer selects the products he wishes to order in the “basket”, modifies if necessary (quantities, references, etc.);
2. the Customer checks the delivery address or provides a new one;
3. shipping costs are calculated and submitted to the Customer, along with the name of the carrier;
4. the Customer checks all the information, acknowledges and accepts these General Terms and Conditions by checking the corresponding box, then invites them to validate their order by clicking on the “Validate my order” button;
5. In order to securely enter their personal bank card details, the Customer is redirected to the secure payment interface PAYPAL, SHOPIFY PAYMENT, APPLE PAY or ALMA. Data relating to payment methods (bank card number, expiration date, authorization number, security code) are collected directly by our service providers. Marmax never has access to its customers' payment data.

Once an order has been validated, the Customer will no longer be able to modify the delivery address.

If the payment is accepted, the order is registered and the contract is definitively formed. Payment by credit card is irrevocable.

Payment is made in one go by credit card (Visa, Mastercard, American Express, Bancontact or Paypal). Banking transactions are carried out and secured by our partner SHOPIFY PAYMENT.

For any order greater than or equal to 200 euros including tax, the Customer can benefit from payment in several installments. To do this, the Customer must choose the corresponding option during the ordering process. Payment is made via the secure ALMA platform. If the Customer wishes to pay for the order in several installments, he accepts the general and specific conditions of ALMA.

The commitment to pay given by means of a payment card is irrevocable. Orders placed on the Site imply the guarantee that the Customer has all the necessary authorizations to use the means of payment made available.

In certain cases, including non-payment, incorrect address or other problem with the Customer's account, Marmax reserves the right to suspend or cancel any order from the Customer until the problem is resolved.

Confirmation of an order implies acceptance of these General Terms and Conditions, acknowledgement of having full knowledge of them and waiver of the right to rely on one's own purchasing conditions. All data provided and the recorded confirmation will constitute proof of the transaction. Marmax will communicate by email to the Customer via the email address provided when creating their account the confirmation of the registration of their order.

The sale will be considered final after confirmation of acceptance of the order and receipt by the seller of the full price.

If the Customer wishes to contact the Marmax company, he can do so either by email to the following address: contact@stellaetsuzie.com; or by post to the following address: Société Marmax, 114 avenue Crampel, 31400 Toulouse.

Article 6. Ownership and transfer of risks
The transfer of ownership and the risks of loss and deterioration relating thereto will only be carried out after full payment of the price by the Customer, regardless of the delivery date. Marmax retains full ownership of the products sold until full payment of the price, including principal, costs and taxes.

Article 7. Withdrawal

For any order placed between December 1 and December 25, 2024 inclusive, returns are extended until January 5.

In accordance with the provisions of Article L221-18 of the Consumer Code, the Customer has a period of fourteen calendar days from receipt of the order to exercise his right of withdrawal and return the Product to the Marmax company for reimbursement without penalty.

The right of withdrawal may be exercised by sending an email to contact@stellaetsuzie.com, or by post using the form attached to these T&Cs. Any other method of declaration of withdrawal is accepted. It must be free of ambiguity and express the desire to withdraw.

The Products must be returned in their original packaging, in perfect condition, new, unworn, unwashed, undamaged, soiled or incomplete within 14 days of notification to Marmax of the Customer's decision to withdraw. Otherwise, they will not be taken back or exchanged.

In order to avoid any deterioration, all Leather Products must be returned with the protective strips. Similarly, bags and hats must also be returned with the padding provided.

For hygiene reasons, on lingerie or swimsuits, the protective tab located between the legs must be present and will be changed before any return to stock.

Marmax reserves the right to refuse the return of Products which do not comply with the conditions referred to above.

Returns are made via a prepaid return label.

For any return made (except those made from the United States and Canada) a flat rate contribution will be charged to the Customer and deducted from their refund if applicable. This flat rate contribution will be 5 euros for returns made from mainland France, the European Union and Switzerland, 5 pounds sterling for those made from the United Kingdom and 10 dollars for the rest of the world.

In the event of a return of the entire order, all sums paid by the Customer, less the "return package", will be refunded by Marmax. The refund will be made no later than 14 (fourteen) days following the date on which Marmax becomes aware of the Customer's decision to withdraw. Marmax may defer the refund until the Products have been recovered or until the Customer has provided proof of shipment of these Products. The return costs shall be borne by Marmax if the Product delivered is different from the Product ordered or damaged. If the Customer fails to comply with these General Terms and Conditions, in particular the return conditions, Marmax will not be able to refund the Products concerned.

Marmax will make the refund using the same means of payment as that which was used for the payment of the order concerned. However, with the express agreement of the Customer, another means may be used, unless the payment of the order was made by gift card or credit. The Customer may thus opt for the issue of a credit, instead of a refund, corresponding to the full amount paid for the initial order. The validity period of the credit is twelve months from its date of issue, it is valid for any future purchase made on the site or in our stores (excluding department store corners).
In the event of a return of your order purchased via a gift card and/or credit, your refund will be made automatically and only in the form of a new credit, other methods of refund, namely cash or payment card, are excluded in this case.
The customer may choose to issue a credit note corresponding to the full amount paid by the customer instead of a refund with a validity period of 12 months.

When Marmax notices abusive activity, including, but not limited to, orders delivered and then returned excessively or multiple returns not in accordance with the conditions cited above having resulted in refusals of returns, Marmax reserves the right to re-invoice the Customer for the return costs in full, not to reimburse the returns and/or to deactivate the account as well as any associated accounts.

If you wish to make a return in accordance with your legal rights after account deactivation, it is possible to contact customer service by sending an email to contact@stellaetsuzie.com.

Article 8. Delivery
Deliveries are made to the address indicated by the Customer on the order form, which can only be in the agreed geographical area. Any package returned to Marmax due to an incorrect or incomplete delivery address will be reshipped at the Customer's expense.

Transport is provided by Colissimo, Chronopost, DHL or Mondial Relay services depending on the option chosen by the Customer when confirming their order.

The delivery times indicated on the Site are indicative times, they correspond to the average processing and delivery times. Marmax cannot be held responsible for the consequences due to a delay in delivery that is not its fault.

However, if delivery times exceed thirty days from the order, the sales contract may be terminated and the Customer reimbursed.

Orders placed by Colissimo, delivery services with tracking, delivery without signature.

Marmax may provide the Customer with the tracking number of their package by email. The Customer is delivered to their home by their postman. In the event of the Customer's absence, they will receive a delivery notice from their postman, which allows them to collect the products ordered from the Post Office or a relay point as close as possible, within a period indicated by the postal services. The risks associated with transport are the responsibility of the Customer from the moment the items are physically received by the latter. The Customer is required to check in the presence of the Post Office employee or delivery person, the condition of the packaging of the goods and their contents upon delivery (or 10 days from receipt to protest to the delivery service).

Article 9. Guarantees
9.1. Legal guarantee of conformity and legal guarantee of hidden defects
The Marmax company guarantees the conformity of the goods to the contract, allowing the Customer to make a request under the legal guarantee of conformity provided for in Articles L.217-4 et seq. of the Consumer Code or the guarantee of hidden defects of the thing sold within the meaning of Articles 1641 et seq. of the Civil Code.

In the event of implementation of the legal guarantee of conformity, it is recalled that:
-the Customer has a period of 2 years from delivery of the goods to take action;
-the Customer may choose to have the goods repaired or replaced depending on available stock, subject to the cost conditions provided for in Article L.217-17 of the Consumer Code;
- the Customer is exempt from providing proof of the existence of the lack of conformity of the goods during the 24 months following delivery of the goods;
- the legal guarantee of conformity applies independently of any possible commercial guarantee.

The Customer may decide to implement the guarantee against hidden defects of the thing sold within the meaning of Article 1641 of the Civil Code. In this case, he may choose between the resolution of the sale or a reduction in the price in accordance with Article 1644 of the Civil Code.

9.2. Terms of implementation of guarantees
The Customer requesting the benefit of the legal guarantee of conformity or hidden defects must send his request to customer service via the email address contact@stellaetsuzie.com. The Customer may return the Product using the return slip sent by the after-sales service.

Prior to this return, the Customer must contact the after-sales service by telephone on 09 83 49 12 75 (Monday to Friday from 9 a.m. to 1 p.m. and 2 p.m. to 6 p.m.) or by email at contact@stellaetsuzie.com.

9.3. Limitation of liability
The liability of Marmax with regard to any Product purchased on the Site is strictly limited to the purchase price of the latter.

Marmax cannot be held liable for any damage resulting from the use of the Internet network such as loss of data, intrusions, viruses, service interruption, or other involuntary problems.

9.4. Force Majeure
In the event of the occurrence of an event falling within the scope of a fortuitous event or a case of force majeure preventing the normal execution of the order or these General Terms and Conditions, the liability of Marmax cannot be incurred. As defined by Article 1218 of the Civil Code, force majeure is an external, unforeseeable and irresistible event. It includes any act, event, non-performance, omission or accident beyond the contract of Marmax.

The execution of these General Terms and Conditions will be suspended for as long as the force majeure event lasts and execution and delivery times will be extended accordingly. Marmax will endeavour, as far as possible, to end the force majeure event or find a solution enabling it to fulfil its contractual obligations.

Article 10. Intellectual Property
The Marmax company is the owner of the domain name stellaetsuzie.com. The Site is an intellectual work protected by intellectual property laws. The Site as a whole and each of the elements that compose it (such as script sources, basic data, films, photographs, logos, brands, designs or models, texts, tree structures, software, animations, illustrations, design, ergonomics, graphics, on the organization and titling of sections) are the exclusive property of the Marmax company.

Any use, reproduction, modification, even partial, of these elements is prohibited without the prior written authorization of the Marmax company.

Article 11. Personal data
The Customer is informed and accepts that his personal data may be collected on the Site and used by the company Marmax which acts as data controller within the meaning of Regulation (EU) 2016/679 of the European Parliament and of the Council of 27 April 2016 on the protection of individuals with regard to the processing of personal data and on the free movement of such data and repealing Directive 95/46/EC (hereinafter "GDPR").

Marmax undertakes to protect and ensure the security and confidentiality of its Customers' personal data in accordance with the GDPR, in particular by taking all useful precautions to prevent this data from being distorted, damaged or accessed by unauthorized third parties.

In particular, the personal data of Customers may be transmitted to service providers and contractual partners who, as subcontractors within the meaning of the GDPR, intervene and contribute directly to the management of orders and for whom it is absolutely necessary to access the personal data provided by the Customer when creating and using their account (identity, postal address, telephone number, e-mail).

Customers’ personal data is collected for the following purposes:
- management of orders and customer relations,
- information for Customers relating to offers and commercial information relating to the brands,
- strengthening and improving the communication of the website and the brand by sending, in particular, newsletters and special offers based on the preferences of the Customer noted on the Site,
- the improvement and personalization of the services offered to Customers,
- compliance with legal and regulatory obligations.

Marmax undertakes to preserve the confidentiality of the information provided by the Customer, which he would be required to transmit for the use of certain services. Any information concerning him is subject to the provisions of Law No. 78-17 of January 6, 1978.

In this respect, the Internet user has the right to access, modify and delete information concerning him/her. He/she may request this at any time by mail to the following address: Société Marmax, 114 avenue Crampel, 31400 Toulouse or by electronic means to: contact@stellaetsuzie.com.

Article 12. Applicable law - Dispute resolution
These T&Cs are subject to French law.

In the event of translation of the Site and the T&Cs, the French language shall prevail for interpretation.

In the event of a dispute, the Customer will contact Marmax as a priority to seek an amicable solution by contacting Customer Service.

If the dispute could not be settled within the framework of the written complaint previously submitted to Customer Service, the Customer has the right to seek free recourse from a consumer mediator with a view to the amicable resolution of the dispute between him and the Marmax company.

The Client may only refer the matter to a mediator if he can prove that he has previously made a written complaint to the professional, and this within the limit of one year following this written complaint.

In the event of a dispute between the Customer and Marmax Company, the Customer may contact the consumer mediator appointed by Marmax Company, in order to resolve the dispute amicably.

The consumer mediator for which Marmax Company is responsible is CM2C. The Customer may use said mediator via its website https://www.cm2c.net/ or by post: 14 rue Saint Jean 75017 Paris.

All costs related to the consumer mediator's appeal will be borne by Marmax Company.

The Customer has the option of registering free of charge on a list to oppose telephone canvassing such as BLOCTEL (www.bloctel.gouv.fr) in order to no longer be canvassed by telephone by a professional with whom you do not have an ongoing contractual relationship, in accordance with law n°2014-344 of March 17, 2014 relating to consumption.

Any consumer has the possibility to register for free on this list on the site https://conso.bloctel.fr/index.php/inscription.php.

#RENCARDTOULOUSAIN COMPETITION

Free competition with no obligation to purchase

Article 1: Organizing company
The company MARMAX, a simplified joint stock company, with capital of 9,803 euros, whose head office is located at 114 avenue Crampel, 31400 Toulouse, registered in the Toulouse trade and companies register under number 833453442, is organizing a game with obligation to purchase.

Article 2: The Game and access to the Game

Participation in the game is free, without obligation to purchase and implies unreserved acceptance of these rules in their entirety (hereinafter “the Rules”).
Participation in the game is reserved for Instagram subscribers.

Article 2: Dates and duration
The competition called #RENCARDTOULOUSAIN will take place from February 21, 2025 at 9:00 a.m. to February 25, 2025 at 4:59 p.m.
The Organizing Company reserves the right to postpone, modify, cancel or renew this game if circumstances require it. In any event, its liability cannot be incurred in this regard.

Article 3: Participation
3.1. Conditions of participation:
The game is open to any adult natural person subscribed to the Instagram account @maisonstellaetsuzie.
To participate, participants must:
1. If you pass by our future store, take a photo of yourself in our window mirror,
2. Post the photo in story (your account must be public)
3. Follow and subscribe to @maisonstellaetsuzie,
4. Tag @maisonstellaetsuzie with #RENCARDTOULOUSAIN
5. Be creative and have fun!

Persons who have participated directly or indirectly in the development of the game, as well as members of their family (same name, same postal address) and employees of the Organizing Company are excluded from any participation in the game. Participations that comply with all the provisions of this article will be accepted. The Organizing Company therefore reserves the right to carry out any checks it deems necessary with regard to the identity and address of each participant. In this regard, any information provided that is incomplete, erroneous, falsified or that does not allow a participant or their contact details to be identified will result in the cancellation of the participation in question. The participation fees for the game will not be refunded.
3.2. Participant’s commitments

Participation in the game implies a loyal attitude, meaning absolute respect for the rules and full acceptance of these rules of the competition. The participant agrees to communicate the mandatory information of article 3.1.

Article 4: Allocations
Each participant plays to try to win:
• An AITANA Maison Stella & Suzie scarf worth forty (40) euros including all taxes.
The prize is nominative, non-exchangeable, non-transferable and non-refundable. No cash equivalent will be given for the prize.
Article 5: Designation of winners
A draw will be made among the participants by the members of the Organizing Company team on February 25, 2025 at 5:00 p.m. Three (3) winners will be drawn.
The Organizing Company will contact the winners by private message on Instagram via the page @maisonstellaetsuzie.com within three (3) working days from the announcement of their win.
The Organizing Company will publish the winner on the Instagram page @maisonstellaetsuzie.com via a story. By participating in the Game, the winner consents to his/her first name and/or Instagram Pseudonym being made public and being displayed on said Instagram page.

Article 6: Delivery of the Lot
The winners will be able to collect their prize at the MAISON STELLA & SUZIE boutique located at 24 rue du Temple in Paris (75004) during opening hours upon presentation of proof of identity before April 31, 2025.

If the email address, if the contact details do not match that of the winner, or if for any other reasons related to technical problems preventing the correct routing of the information of the prize, the Organizing company cannot be held responsible under any circumstances. Similarly, it is not up to the Organizing company to search for contact details of winners who cannot be reached due to an invalid or illegible email address, or an incorrect postal address or an invalid telephone number.
The lot awarded is personal and non-transferable.
If the winner were to refuse the prize, no compensation may be requested. Indeed, the prize may not under any circumstances be the subject of any dispute on the part of the winner, nor of an exchange or any other consideration of any nature whatsoever.
The lot awarded is personal and non-transferable.
If the lot cannot be returned within the aforementioned periods, the lot will not be subject to a new allocation.

Article 7: Liability
The participant acknowledges and accepts that the sole obligation of the Organizing Company under the game is to submit the collected entries to the draw, provided that their entry complies with the terms and conditions of the Rules, and to award the prize to the winner, according to the criteria and terms defined in these Rules.
The Organizing Company cannot be held responsible, without this list being exhaustive, for any malfunction preventing the smooth running of the Game, in particular due to external malicious acts. The Organizing Company cannot be held responsible for any technical defect or problem.
The Organizing Company may cancel or suspend all or part of the game if it appears that fraud has occurred in any form whatsoever in the context of participation in the Game. In this case, it reserves the right not to award the prize to the fraudsters and/or to prosecute the perpetrators of this fraud before the competent courts.

Article 8: Protection of personal data
The personal data of participants is collected for the purposes of participation in the game described in these rules and will be kept for this purpose for the duration of the game. This information is intended for the Organizing Company acting as data controller.
This information is mandatory to participate in the Game, as it is necessary to determine the winner(s) and to award and deliver the prizes. Consequently, persons who exercise the right to delete their data before the end of the Game are deemed to have waived their participation.
In application of European laws and the law of January 6, 1978 (relating to information technology, files and freedoms), you have the rights of access, rectification, limitation, portability and deletion of your personal data as well as the right to oppose their processing for legitimate reasons. You can exercise all of these rights by email to the address contact@stellaetsuzie.com or by post to: MARMAX, 114 avenue crampel, 31400 Toulouse.
You also have the right to withdraw your consent at any time and to file a complaint with the National Commission for Information Technology and Civil Liberties (CNIL), in particular on its website www.cnil.fr.
Article 9: The regulation:
Participation in this game implies full and complete acceptance of these Rules (hereinafter the “Rules”).
The Organizing Company reserves the right to cancel, postpone, extend, shorten or modify this game in part or in full in the event of force majeure or exceptional circumstances. These rules may be modified at any time by the Organizing Company in the form of an amendment.
Cases not provided for in the Rules will be decided by the organizers of the game and their decision will be final, French law being the only applicable law. Disputes will only be admissible within two weeks after the closing of the competition. The Organizing Company cannot be held responsible if, for reasons beyond its control (unforeseeable circumstances or force majeure as well as any other event making it impossible to run the competition under the conditions initially planned), the competition is partially or totally modified, postponed or canceled. A copy of the rules can be obtained free of charge by written request to Marmax via the email address contact@stellaetsuzie.com.

Article 10: Applicable law and disputes
This game and these Rules are subject to French law.
Any dispute concerning the interpretation of the Regulations and/or cases not provided for by these Regulations will be subject to amicable settlement.
Failing this, it will be subject to the French courts. The competent court will be that of the consumer's domicile.

Done in Toulouse, February 19, 2025

Withdrawal form

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

To the attention of: Marmax Company - 114 Avenue Crampel - 31400 Toulouse.

Email: contact@stellaetsuzie.com:

I hereby notify you of my withdrawal from the contract relating to the sale of the property below: (identify the Product)

Ordered on ………………………….……. (date) / Received on: ………………………….……. (date)
Customer Name: Customer Address:
Signature of the Client (only in the event of notification of this form on paper):
Date :