British Mouldings will be closed from 25th December and will reopen again on 5th January - Any orders placed during this time will be processed from January 5th.

Please note: British Mouldings Will be closed between 24.12.24 and 02.01.25

Consumer Terms of Sale

Last updated: 1 June 2026

Please read these Terms of Sale carefully before placing an order with us.

These Terms of Sale set out the terms under which Goods are sold by British Mouldings to consumers.

These Terms apply where you are purchasing Goods wholly or mainly outside your trade, business, craft or profession.

If you are purchasing wholly or mainly for business, trade, craft or professional purposes, our separate Business Terms of Sale apply instead.

Nothing in these Terms affects your statutory rights as a consumer.

1. Definitions and interpretation

In these Terms, the following expressions have the following meanings:

“Contract” means the contract between you and Us for the purchase and sale of Goods.

“Goods” means the goods supplied by Us under the Contract.

“Order” means your order for Goods.

“Order Confirmation” means Our acceptance and confirmation of your Order.

“Order Number” means the reference number allocated to your Order.

“Our Site” means the British Mouldings website.

“We”, “Us” and “Our” mean Decorative Mouldings UK Ltd, trading as British Mouldings.

References to “writing” or “written” include email.

References to legislation include that legislation as amended or replaced from time to time.

2. Information about Us

British Mouldings is a trading name of:

Decorative Mouldings UK Ltd
Company number: 11175315
VAT number: 287498042

Registered and trading address:

8 Hurricane Way
Norwich
Norfolk
NR6 6EY

Email: info@britishmouldings.co.uk
Telephone: 01603 940 444

3. About these Terms

These Terms apply to the sale of Goods by Us to consumers.

You should read these Terms before placing an Order.

Our Returns & Refunds Policy also applies to consumer Orders and provides further information about cancellations, returns, refunds and damaged or faulty Goods.

Our Privacy Policy, Cookie Policy and Website Terms of Use also apply where relevant.

We may update these Terms from time to time. The version applying to your Contract will normally be the version in force when your Order is accepted by Us.

If We need to make a change to your Contract that materially affects you after it has been formed, We will contact you where required.

4. Consumer and business customers

These Terms apply only where you are acting as a consumer, meaning that you are purchasing Goods wholly or mainly outside your trade, business, craft or profession.

If you are purchasing Goods wholly or mainly for business, trade, craft or professional purposes, our Business Terms of Sale apply.

Providing a company name, business address or other business information does not necessarily determine whether you are acting as a consumer. Your status depends on the purpose for which you are making the purchase.

Where requested during the ordering process, you should accurately indicate whether you are purchasing as a consumer or as a business or trade customer.

5. Goods and product descriptions

We make reasonable efforts to ensure that descriptions, measurements, photographs and other information about Goods are accurate.

Images are for illustrative purposes. Colours and appearance may vary slightly because of lighting, photography, screen settings and the handmade nature of the Goods.

Packaging may also differ from images shown on Our Site.

Measurements and weights stated on Our Site are approximate unless expressly stated otherwise.

Minor variations that are inherent in the traditional manufacturing process do not necessarily mean that Goods are defective or do not correspond with their description.

Nothing in this section excludes or restricts your statutory rights where Goods are not as described or otherwise do not conform to the Contract.

6. Handmade fibrous plaster

Our fibrous plaster mouldings are traditionally manufactured by hand.

As a result, minor variations can occur between individual pieces.

Depending on the product, these may include minor surface variations, casting marks, minor hairline marks and slight variations inherent in the traditional manufacturing process.

These characteristics do not necessarily indicate that Goods are defective.

Fibrous plaster is rigid and comparatively heavy and requires appropriate handling, installation and finishing.

Traditional fibrous plaster mouldings are intended to be installed and finished by an appropriately competent person. Normal installation and finishing can include filling joints and fixing points and appropriate preparation before decoration.

Nothing in this section affects your statutory rights where Goods are faulty, not of satisfactory quality, not as described, not fit for a particular purpose made known to Us, or otherwise do not conform to the Contract.

7. Product suitability, quantities and installation

You are responsible for checking the product information, measurements and approximate weights provided before ordering and considering whether the Goods are suitable for your intended location and installation.

Ceiling roses and other heavier mouldings require an appropriate fixing method and suitable structural support.

If you are unsure about the suitability of a product, fixing method or supporting structure, We recommend seeking advice from an installer experienced with traditional fibrous plaster before ordering or installation.

Where you ask Us for advice about a particular application, you should provide sufficient and accurate information about the proposed installation to enable Us to provide appropriate guidance.

For cornice, panel mouldings and other products that require cutting and joining, you should allow sufficient material for cuts, wastage and site conditions.

As a general guide, We recommend allowing at least 10% additional material for products requiring cutting. The appropriate allowance will depend on the dimensions, layout and complexity of the individual project.

Ordering sufficient material initially can help avoid additional manufacturing time and further delivery charges.

8. Customised and bespoke Goods

Most British Mouldings Goods are handmade to fulfil individual Orders. The fact that a standard product is manufactured after an Order is placed does not, by itself, mean that it has been made to your individual specifications.

Some Goods, however, are genuinely made to customer-specific requirements.

These may include:

  • mouldings manufactured to non-standard customer-specific dimensions;

  • bespoke designs;

  • reproductions produced from customer-supplied samples or designs;

  • specially produced tooling or moulds;

  • Goods manufactured to other individual specifications supplied or selected by you; and

  • standard Goods subsequently altered or modified specifically at your request.

Where Goods are made to your specifications or are clearly personalised, the statutory change-of-mind cancellation right may not apply.

Where a particular product or modification is treated as customised, We will provide appropriate information during the ordering process.

Nothing in this section affects your statutory rights if customised or bespoke Goods are faulty, damaged, misdescribed or otherwise do not conform to the Contract.

9. Prices and VAT

We take reasonable care to ensure that prices shown on Our Site are correct.

Prices displayed on Our Site may be shown both excluding VAT and including VAT.

Where Goods are offered to consumers, the applicable VAT-inclusive price will be clearly displayed.

Delivery charges are additional unless expressly stated otherwise and will be shown or calculated during the ordering process before you place your Order.

The total amount payable will be shown before you complete your purchase.

If the VAT rate changes between your Order being placed and the Goods being supplied, We will make any adjustment required by law.

If We discover an obvious error in the price of Goods before accepting your Order, We will contact you.

Where the correct price is lower, We may charge the lower price.

Where the correct price is higher, We will normally give you the option to proceed at the correct price or cancel the affected Goods.

We will not knowingly proceed with an Order at an obviously incorrect price.

10. Placing an Order

Our Site will guide you through the ordering process.

Before submitting your Order, you will have an opportunity to review the Goods, quantities, delivery method and other information supplied.

Please check your Order carefully before submitting it.

In particular, you should check:

  • product references and descriptions;

  • measurements and dimensions;

  • quantities;

  • any selected options or modifications;

  • delivery or collection details; and

  • your contact information.

If you discover an error after placing your Order, please contact Us as soon as possible.

Because Goods may enter production after your Order has been accepted and payment received, amendments may not always be possible once production has begun.

Any statutory right you may have to cancel the Contract is separate from Our ability to amend an Order that is already in production.

11. How the Contract is formed

The information on Our Site does not constitute a contractual offer by Us.

By submitting an Order, you make an offer to purchase the Goods shown in your Order.

For online Orders, payment is taken as part of the checkout process. Taking payment does not by itself mean that We have accepted your Order.

We accept your Order when We send you an Order Confirmation.

A legally binding Contract between you and Us is formed when We send the Order Confirmation.

The Order Confirmation will normally contain your Order Number and details of the Goods ordered, pricing and applicable delivery or collection information.

Please quote your Order Number when contacting Us about an Order where possible.

If We cannot accept your Order, We will inform you and refund any payment We have received for the affected Goods.

Reasons We may be unable to accept an Order include an error in price or product information, inability to manufacture or supply the Goods, inability to deliver to the requested location, or other circumstances that reasonably prevent Us from fulfilling the Order.

12. Payment

Payment for Goods and any applicable delivery charges must be made in advance unless We have expressly agreed otherwise with you in writing.

For Orders placed through Our Site, payment is taken in full as part of the checkout process.

For Orders placed directly with Us by telephone, email or another offline method, We will normally issue an invoice or payment request. Production will not begin until the required payment has been received in cleared funds.

For certain larger or higher-value Orders, We may agree an alternative payment arrangement with you.

Any alternative payment arrangement must be expressly agreed with Us and will apply only to the particular Order concerned.

Where an alternative payment arrangement is agreed, the payment amounts and due dates will be confirmed in writing.

We will not normally begin manufacturing or preparing Goods for your Order until the payment required before production has been received.

13. Production and estimated lead times

Our fibrous plaster mouldings are traditionally handmade and most Goods are manufactured to fulfil individual Orders.

The lead time displayed during checkout or otherwise communicated to you reflects Our estimated production and delivery times based on factors including the Goods ordered, quantities, manufacturing requirements, delivery method and Our production workload at the time.

Unless We expressly agree a fixed delivery date with you in writing, lead times and delivery dates provided by Us are estimates rather than guaranteed delivery dates.

Because our Goods are handmade and production requirements can vary, actual manufacturing and delivery times may occasionally be longer than initially estimated.

We will make reasonable efforts to complete and supply your Order within the estimated timeframe and will contact you where We become aware of a material delay.

If you require Goods by a particular date, please tell Us before placing your Order. A particular date will only be treated as an agreed or guaranteed delivery date where We have expressly confirmed this to you.

Nothing in this section affects your statutory rights in relation to delivery.

14. Delivery and collection options

Depending on the Goods ordered and your location, the available fulfilment methods may include:

Collection from Norwich

Small Item Delivery

Large Item Delivery

The methods available for your Order and any applicable charges will be shown or communicated before your Order is confirmed.

15. Collection from Norwich

Where you select Collection from Norwich, We will notify you when your Goods are ready for collection.

Goods may be collected from:

British Mouldings
8 Hurricane Way
Norwich
Norfolk
NR6 6EY

Please do not attend to collect your Order until We have confirmed that it is ready.

You are responsible for providing a suitable vehicle and appropriately protecting and securing the Goods once they have been handed over to you.

If somebody else will collect on your behalf, We may ask for reasonable information to verify that they are authorised to collect the Order.

Responsibility for the Goods passes to you when you, or a person or carrier arranged by you, takes physical possession of them.

16. Small Item Delivery

Goods suitable for parcel transport may be supplied using our Small Item Delivery service.

Small Item Delivery is carried out using a third-party courier or parcel carrier.

Some Goods may require a signature or somebody to be available to receive the delivery.

Please inspect the Goods as soon as reasonably possible after delivery.

If Goods appear to have been damaged in transit, please follow the procedure in Part 21 and our Returns & Refunds Policy.

17. Large Item Delivery

Large, long or particularly fragile Goods, including 3 metre cornice and other mouldings unsuitable for normal parcel networks, may require our Large Item Delivery service.

Large Item Delivery is normally carried out using our own delivery vehicles or another suitable delivery arrangement selected by Us.

You are responsible for providing accurate delivery information and informing Us of relevant access restrictions or circumstances that could reasonably affect delivery.

Someone should be available to receive the Goods at the agreed delivery location and time.

Unless expressly agreed otherwise, delivery is to a suitable accessible point at the delivery address. You should ensure that suitable assistance is available where reasonably necessary to move or handle Goods after delivery.

Responsibility for the Goods passes to you when the Goods are delivered into the physical possession of you or a person identified by you to take possession of them.

18. Delivery and delays

We will make reasonable efforts to manufacture and supply your Goods in accordance with the estimated lead time provided during the ordering process.

Unless We expressly agree a fixed delivery date or period with you, any production or delivery dates provided by Us are estimates and may be affected by manufacturing requirements, order volumes, transport arrangements and circumstances outside Our reasonable control.

Where no different delivery time or period has been agreed between you and Us, your statutory rights concerning the time for delivery will apply.

If We become aware that your Order is likely to be materially delayed, We will contact you where appropriate.

Where the law gives you the right to require delivery within an additional reasonable period or to end the Contract because of a delay, nothing in these Terms restricts those rights.

19. Failed deliveries and redelivery

You are responsible for ensuring that the delivery address, telephone number, email address and relevant access information supplied to Us are accurate.

You should also make reasonable arrangements to receive the Goods where somebody is required to be present.

Small Item Delivery

Our courier may make more than one attempt to deliver your Order.

Where Goods are returned to Us following repeated unsuccessful delivery attempts for reasons attributable to you, or because information supplied by you was incorrect or incomplete, We may require payment of a reasonable redelivery charge before dispatching the Goods again.

Large Item Delivery

Where an agreed Large Item Delivery cannot be completed because nobody is available to receive the Goods, suitable access has not been provided, or materially incorrect or incomplete delivery information has been supplied, the Goods may be returned to Our Norwich premises.

Where the failed delivery was attributable to you, We may charge the reasonable additional costs incurred in making a further Large Item Delivery.

If you instead have and exercise a statutory right to cancel the Contract, any refund will be dealt with in accordance with your statutory rights, these Terms and our Returns & Refunds Policy.

We will not use a failed-delivery charge to remove or restrict a statutory cancellation right.

20. Ownership and responsibility for the Goods

Ownership of the Goods passes to you once We have received payment in full for them.

Responsibility for the Goods passes to you when:

  • for Small Item Delivery or Large Item Delivery, the Goods come into the physical possession of you or a person identified by you to receive them; or

  • for Collection from Norwich, you or a carrier or other person arranged by you takes physical possession of the Goods.

If you independently arrange for a carrier that was not offered by Us to collect the Goods, responsibility will normally pass when the Goods are handed to that carrier, as provided by law.

Ownership and responsibility for the Goods are separate concepts.

21. Damaged, faulty or incorrect Goods

Goods supplied by Us must meet your statutory rights, including applicable requirements that they are of satisfactory quality, fit for purpose and as described.

Please inspect your Goods as soon as reasonably possible after Small Item Delivery, Large Item Delivery or Collection from Norwich.

If you believe Goods have arrived damaged, are faulty, incorrect, not as described or otherwise do not conform to the Contract, please contact Us promptly.

Where possible, We ask that visible transit damage following Small Item Delivery or Large Item Delivery is reported within 48 hours. Prompt notification helps Us investigate the circumstances and, where applicable, raise the matter with the carrier.

Failure to report transit damage within 48 hours does not affect your statutory rights.

We may ask you to provide photographs and other relevant information. This may include photographs of the Goods, the affected area, internal packaging, external packaging and any visible damage to the packaging.

Please retain the affected Goods and their packaging until We have assessed the issue and confirmed whether the Goods should be returned, inspected or disposed of.

Please do not repair, alter, install or dispose of Goods you believe to be defective unless We have agreed that you may do so.

Depending on the circumstances and your statutory rights, the appropriate remedy may include repair, replacement, price reduction, rejection and refund, or another remedy provided by law.

Where Goods are genuinely faulty, damaged when delivered, misdescribed or otherwise non-conforming, We will bear reasonable return costs where required by law.

For some Goods, We may decide that returning them is unnecessary and provide the appropriate remedy without requiring their return.

Where an alleged problem cannot reasonably be determined from photographs or other information, We may need to inspect the Goods before determining the appropriate remedy.

22. Problems caused after delivery or collection

We are not responsible for damage or defects caused after responsibility for the Goods has passed to you where the problem results from inappropriate handling, storage, installation, alteration, repair, misuse or other action by you or a third party.

This may include damage caused by unsuitable fixing methods, inadequate structural support or inappropriate handling of fragile fibrous plaster.

This does not affect your rights where an underlying fault or non-conformity existed when responsibility for the Goods passed to you.

If you are unsure whether an issue is a manufacturing characteristic, installation issue or potential defect, please contact Us before carrying out repairs or alterations.

23. Your right to change your mind

If you are a consumer purchasing at a distance, you will normally have a statutory right to cancel the Contract without giving a reason.

For most Goods, the cancellation period ends 14 days after the day on which you, or a person nominated by you, receives the Goods.

Where an Order consists of multiple Goods delivered on different days, the cancellation period may run from receipt of the final Goods.

Where you select Collection from Norwich, the relevant period will normally run from the day you collect the Goods.

You may also tell Us that you wish to cancel before receiving the Goods.

To exercise your right to cancel, you must make a clear statement informing Us of your decision.

You can contact Us using the details in Part 2.

You do not have to give a reason for exercising a statutory change-of-mind cancellation right.

24. Exceptions to the change-of-mind cancellation right

The statutory change-of-mind cancellation right does not apply in certain circumstances provided by law.

Relevant exceptions may include Goods that are made to your specifications or are clearly personalised.

As explained in Part 8, the fact that a standard catalogue product is manufactured after your Order is placed does not, by itself, mean that the product has been made to your specifications.

The exception may apply where Goods have genuinely been manufactured or subsequently modified to your individual requirements.

The cancellation right may also cease to apply where Goods become inseparably mixed with other items after delivery where the applicable statutory exception applies.

These exceptions do not affect your rights where Goods are faulty, damaged, misdescribed or otherwise do not conform to the Contract.

25. Returning Goods after a change-of-mind cancellation

If you exercise a statutory change-of-mind cancellation right after receiving the Goods, you are responsible for returning them to Us.

You must normally send or hand the Goods back within 14 days after informing Us of your decision to cancel.

Unless We agree otherwise, Goods should be returned to:

British Mouldings
Decorative Mouldings UK Ltd
8 Hurricane Way
Norwich
Norfolk
NR6 6EY

If you are returning Goods because you have changed your mind, you are responsible for arranging and paying the direct cost of suitable return transport, provided We have given you the information required by law.

British Mouldings does not normally arrange collection of change-of-mind returns.

Products originally supplied using Small Item Delivery may be suitable for return using an appropriate parcel courier.

Products requiring Large Item Delivery, including 3 metre cornice and other large or fragile plaster mouldings, cannot normally be returned using standard postal or parcel services.

As an indication of the potential cost of arranging suitable specialist return transport, We estimate the maximum return transport cost at approximately:

England and Wales: £660 including VAT per van journey

Scotland: £840 including VAT per van journey

These figures are provided solely as an indication of the potential cost of arranging suitable specialist return transport.

They are not British Mouldings collection charges and do not constitute an offer by Us to collect returned Goods.

Actual costs may be lower depending on your location, the Goods being returned and the transport provider you choose.

Further information about packaging and arranging a return is provided in our Returns & Refunds Policy.

26. Taking care of Goods being returned

Fibrous plaster is fragile.

You should take reasonable care of Goods while they are in your possession and package them appropriately for return.

Where reasonably possible, We recommend retaining and reusing the original packaging.

Ceiling roses and similar fragile mouldings should be well wrapped, centrally positioned within suitable outer packaging, protected against movement and given additional protection around edges and other vulnerable areas.

Voids should be securely filled to minimise movement.

Cornice and other long mouldings should be adequately supported and protected along their length and at vulnerable edges and ends.

We strongly recommend using a reputable, trackable transport service with adequate insurance or other cover for the value of the Goods.

We also recommend photographing the Goods before packing and once packed and retaining photographs, tracking information and proof of dispatch until the return has been completed.

27. Diminished value of returned Goods

You are entitled to handle Goods to the extent reasonably necessary to establish their nature and characteristics.

If you exercise a statutory change-of-mind cancellation right and the value of the Goods has been reduced because you handled them beyond what was reasonably necessary, We may make an appropriate deduction from your refund where permitted by law.

Depending on the circumstances, this may include Goods that have been cut, drilled, filled, sanded, painted, installed, fixed, materially damaged or otherwise altered.

Any deduction will reflect the actual reduction in value of the Goods.

We do not impose an arbitrary cancellation or restocking fee on consumers exercising a statutory cancellation right.

28. Refunds following a change-of-mind cancellation

Where you validly exercise a statutory change-of-mind cancellation right, We will refund the price paid for the relevant Goods.

We will also refund the applicable standard outbound delivery charge.

If you expressly chose a more expensive delivery service than the least expensive standard delivery option available for your Order, We are not required to refund the additional cost of the premium service.

Where Collection from Norwich was selected and no delivery charge was paid, there is no outbound delivery charge to refund.

Where permitted by law, We may make an appropriate deduction for diminished value as described in Part 27.

Refunds will normally be made using the same payment method used for the original transaction unless otherwise agreed.

Where you are responsible for returning Goods, We may withhold reimbursement until We have received the Goods back or you provide evidence that they have been sent back, whichever occurs first, where permitted by law.

We will make refunds within the applicable statutory timescales.

29. Ending the Contract because of something We have done

You may have a right to end the Contract in circumstances including where:

  • We have told you about a material change to the Goods or Contract that you do not agree to;

  • We have told you about an error in the price or description and you do not wish to proceed;

  • there is a substantial risk that supply will be significantly delayed because of circumstances outside Our reasonable control;

  • We have failed to deliver within a legally binding deadline; or

  • you otherwise have a statutory right to end the Contract because of something We have done.

Where you validly end the Contract for such a reason, We will provide the refund or other remedy required by law.

Where Goods need to be returned because of Our breach, fault or other circumstances for which We are legally responsible, We will bear reasonable return costs where required by law.

30. Changes and cancellations before production

If you need to change an Order, please contact Us as soon as possible.

We will try to accommodate reasonable amendments where production has not begun.

Once production has begun, amendments may not be possible or may require additional work and cost.

Where you request an amendment that We are able to accommodate, We will tell you about any change in price, production time or delivery arrangements before proceeding where appropriate.

Our practical ability to amend an Order is separate from any statutory cancellation right you may have.

For genuinely customised or bespoke Goods falling within a statutory cancellation exception, cancellation rights may be restricted as explained in Parts 8 and 24.

31. Our liability to consumers

We are responsible for losses you suffer that are a foreseeable result of Our breach of the Contract or Our failure to use reasonable care and skill.

We are not responsible for losses that are not foreseeable.

These Consumer Terms apply to Goods purchased wholly or mainly for domestic and private purposes.

If you use Goods for a business or commercial purpose, different rules may apply and our Business Terms of Sale may be relevant.

Nothing in these Terms excludes or limits liability where it would be unlawful to do so.

This includes liability for death or personal injury caused by Our negligence, fraud or fraudulent misrepresentation, or your statutory rights as a consumer.

32. Events outside Our reasonable control

We will not be responsible for failure or delay in performing Our obligations where that failure or delay results from circumstances outside Our reasonable control.

Such circumstances may include disruption to transport networks, severe weather, fire, flood, industrial disputes, failure of utilities, major equipment failure, shortages of materials caused by circumstances outside Our reasonable control, or other events that We could not reasonably prevent.

If such an event materially affects your Order, We will contact you where appropriate and take reasonable steps to minimise the effect.

Your statutory rights, including any applicable right to end the Contract because of substantial delay, are not affected.

33. Complaints

If you have a complaint about your Order, Goods or our service, please contact Us:

Email: info@britishmouldings.co.uk
Telephone: 01603 940 444

or write to:

British Mouldings
Decorative Mouldings UK Ltd
8 Hurricane Way
Norwich
Norfolk
NR6 6EY

We will make reasonable efforts to resolve complaints fairly and promptly.

Nothing in this complaints procedure affects your statutory rights.

34. Personal information

We will use your personal information in accordance with our Privacy Policy and applicable data protection law.

Please refer to the Privacy Policy available on Our Site for further information about how We collect, use and protect personal information.

35. Transferring the Contract

We may transfer Our rights and obligations under the Contract to another organisation.

If this happens and the transfer could materially affect your rights, We will inform you as required by law.

You may only transfer your rights or obligations under the Contract to another person where We agree in writing or where the law permits you to do so.

36. Other important terms

The Contract is between you and Us. No other person has a right to enforce its terms except where the law expressly provides otherwise.

If any provision of these Terms is found to be unlawful, invalid or unenforceable, that provision will be treated as removed to the extent necessary. The remaining provisions will continue in effect.

If We delay in enforcing a provision of the Contract, this does not mean that We have waived Our right to enforce it later.

A waiver relating to one breach does not automatically waive any later breach.

37. Governing law and jurisdiction

These Terms and the Contract are governed by English law.

If you live in Scotland, Wales or Northern Ireland, you will also benefit from any mandatory consumer protections applicable to you in your place of residence.

Nothing in these Terms removes or reduces any mandatory legal rights you have as a consumer.

Any dispute relating to these Terms or the Contract may be dealt with by the courts having jurisdiction under applicable consumer law.

 

Appendix 1 – Model Cancellation Form

Complete and return this form only if you wish to cancel your Contract. You do not have to use this form and may instead contact us by making any other clear statement that you wish to cancel.

To:

British Mouldings
Decorative Mouldings UK Ltd
8 Hurricane Way
Norwich
Norfolk
NR6 6EY

Email: info@britishmouldings.co.uk

I/We hereby give notice that I/We cancel my/our Contract for the sale of the following Goods:

Goods:

…………………………………………………………………………

Order number:

…………………………………………………………………………

Ordered on / received on:

…………………………………………………………………………

Name of consumer(s):

…………………………………………………………………………

Address of consumer(s):

…………………………………………………………………………

…………………………………………………………………………

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

…………………………………………………………………………

Date:

…………………………………………………………………………