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Model withdrawal form

Version 1.2 · Effective: December 1, 2026

Fill in and send this form only if you wish to withdraw from your contract with SimplyForms within the 14-day period under Section 1829 of the Czech Civil Code. The template is based on Annex 2 to Government Regulation No. 363/2013 Coll.

Note — Sections 1837(a) and 1834 of the Czech Civil Code: If at paid-plan activation you requested that the Service begin immediately, you may withdraw within the 14-day period, but you will pay a proportionate part of the price for the period during which the Service was provided to you; the remainder will be refunded to you. Once the Service has been fully performed for the period paid for, the right of withdrawal lapses. For more see clauses 17.3 and 17.4 of the Terms of Service.

Addressee

Adam Todt Business ID (IČO): 19197438 Tax ID (DIČ): CZ8909294592 (identified person, NOT a VAT payer) Drahy 1625, 696 42 Vracov, Czech Republic Email: legal@simplyforms.app

Notice of withdrawal

I hereby give notice that I withdraw from my contract for the provision of the following service:

Service: SimplyForms — Form Backend as a Service

Plan: (fill in: FREE / STANDARD / EXTEND / ENTERPRISE)

Contract date (registration): ___________________________________________

Paid-plan activation date (if applicable): ______________________________

Form ID: ______________________________________________________________

Account email: ________________________________________________________

Consumer name: ________________________________________________________

Consumer address:

Consumer email (if different from account email): ______________________

Date: _________________________________________________________________

Consumer signature (only if this form is sent on paper):

Delivery options

  1. Email (recommended): scanned or photographed completed form, or plain text, to legal@simplyforms.app
  2. Postal mail: Adam Todt, Drahy 1625, 696 42 Vracov, Czech Republic

We will send an email acknowledgement of receipt without undue delay after receiving the withdrawal.

Consequences of withdrawal

On successful withdrawal:

  • The paid subscription is cancelled as of the date of delivery of the withdrawal and the Account moves to the FREE plan. If you withdraw from the entire contract (including the FREE account), the Account is deactivated and the API key invalidated.
  • Refund of paid Fees: within 14 days of receipt of the withdrawal, to the payment method from which the payment was made; the refund is technically issued by Paddle as the seller.
  • Proportionate payment: if you requested that the Service begin immediately (Section 1837(a) of the Czech Civil Code), you will pay a proportionate part of the price for the period from activation until delivery of the withdrawal (the price of the period × the number of days of use / the number of days in the period, Section 1834 of the Czech Civil Code); the remainder is refunded.
  • Configuration data (email templates, webhook settings) should be exported in the dashboard before the Account is deleted; upon deletion of the Account it is deleted immediately.

Out-of-court dispute resolution

In the event of a dispute, please contact the Czech Trade Inspection:

Consumers domiciled in another EU Member State may contact the European Consumer Centre Czech Republic: www.evropskyspotrebitel.cz.

Version 1.2 · Effective: December 1, 2026

Document hash (SHA-256): 43861266ff7f3efc17a8d91cd1fd4fefba1a428d81473aaa0dc0ea91e42cd553

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