ONLINE PURCHASE WITHDRAWAL FORM

(Complete and return this forms only if you wish to withdraw from your contract of sale)

I hereby give notice that I cancel the contract that I concluded concerning the purchase of the following jewel (s):

In accordance with legal provisions (article L.221-18 and following of the French Consumer Code), please refund my payment (in XPF)

representing the total amount of my order here above mentioned, as soon as you receive the jewel (s) returned on

by registered mail, at my own expense, to the following address:

SARL PERLE MON AMOUR
B.P. 21286
98713 PAPEETE – TAHITI
Polynésie Française
Email: perlemonamour@mail.pf
Phone: +68987770232