Annex I. Model withdrawal form

(Complete and send this form only if you wish to withdraw from the contract.)

To GAIA AGROTECH VENTURES, S.L., Avenida Diagonal, 640, 4th floor, Local E, 08017 Barcelona — email: info@mascliment.com

I/We hereby give notice that I/we withdraw from my/our contract of sale of the following goods:

— Ordered on / received on:

— Name of consumer(s):

— Address of consumer(s):

— Signature of consumer (only if this form is submitted on paper):

— Date: