Refusal of imposed services
Request to refuse additional paid services
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[Company name]
[Company address]
from [Full name]
Address: [Address]
Phone: [Phone]
REQUEST
to refuse imposed/added services
I was imposed additional paid services:
[Description of imposed services]
I did not consent to receiving these services / I was not provided with full information about their cost and conditions.
According to Article 19 of the Law of Ukraine “On Consumer Rights Protection”, unfair commercial practices are prohibited, including imposing goods and services.
Based on the above, I REQUEST:
1. Cancel the imposed services.
2. Refund the paid amount for the imposed services.
4/12/2026 _________________ / [Full name] /
(signature)