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Appendix No. 1
to the Rules for refunding money
To buyers for purchased Tickets
International House of Tea LLC
From _________________________________________
Passport: series _________ No. _________________________
Iss. _______________________________________
_________________________ from ________________
Registration address___________________________
___________________________________________
Statement
I, ___________________________________________, request a refund of the cost of tickets for the event ________________________________________________________________ date ________________20___, in the amount of ___ pieces, for a total of _________________(____________________________________________) rubles, purchased by me from International House of Tea LLC via the Internet.
Email (e-mail address) specified during registration: ___________________________________________________________________________
Details for transferring funds (required):
Full name of the cardholder:___________________________________________________
Name of the recipient bank:__________________________________________
TIN: __________________________________________________________________
Correspondent account: _________________________________________________________________
BIC: __________________________________________________________________
Account account: ___________________________________________________________________
Card number: ______________________________________________________________
I cannot attend the event due to: _________________________________
Order number___________________________________________________________
I have been explained and understand the refund to the applicant in the amount of the ticket price minus the actual expenses incurred by the event organizer
Date_______________________signature_________________________________
I give my consent to the processing and storage of my personal data, in accordance with the Federal Law "On Personal Data" dated 27.07.2006 N 152-FZ
signature __________________________