{load_language_text section="withdrawal"}

{block name="withdrawal_pdf_form"}
	<span style="font-size: 12px;"><b><u>{$txt.withdrawal_form}</u></b><br /><br /></span>
	{$txt.withdrawal_hint}
	<br /><br /><br />
	{$txt.to}:
	&nbsp;<br />&nbsp;<br />
	{$smarty.const.COMPANY_NAME}<br />
	{$smarty.const.TRADER_FIRSTNAME} {$smarty.const.TRADER_NAME}<br />
	{$smarty.const.TRADER_STREET} {$smarty.const.TRADER_STREET_NUMBER}<br />
	{$smarty.const.TRADER_ZIPCODE} {$smarty.const.TRADER_LOCATION}<br />
	{$smarty.const.STORE_COUNTRY_NAME}<br />
	{if $smarty.const.TRADER_FAX != '' || $smarty.const.STORE_OWNER_EMAIL_ADDRESS != ''}
	&nbsp;<br />
	{/if}
	{if $smarty.const.TRADER_FAX != ''}
	{$txt.fax}: {$smarty.const.TRADER_FAX}<br />
	{/if}
	{if $smarty.const.STORE_OWNER_EMAIL_ADDRESS != ''}
	{$txt.mail}: {$smarty.const.STORE_OWNER_EMAIL_ADDRESS}
	{/if}
	&nbsp;<br />&nbsp;<br />&nbsp;<br />
	{$txt.withdrawal_products_hint}
	&nbsp;<br />&nbsp;<br />
	<HR>
	&nbsp;<br />
	<HR>
	&nbsp;<br />
	<HR>
	&nbsp;<br />
	<HR>
	&nbsp;<br />
	<HR>
	&nbsp;<br />&nbsp;<br />&nbsp;<br />
	{$txt.ordered_on} / {$txt.delivered_on}
	&nbsp;<br />&nbsp;<br />&nbsp;<br />&nbsp;<br />
	{$txt.first_last_name}
	&nbsp;<br />&nbsp;<br />
	<HR>
	&nbsp;<br />&nbsp;<br />&nbsp;<br />
	{$txt.address}
	&nbsp;<br />&nbsp;<br />
	<HR>
	&nbsp;<br />
	<HR>
	&nbsp;<br />
	<HR>
	&nbsp;<br />&nbsp;<br />
	&nbsp;<br />&nbsp;<br />
	______________&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;_____________________________________________________
	&nbsp;<br />&nbsp;<br />
	{$txt.date}&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;{$txt.signature}
	&nbsp;<br />&nbsp;<br />&nbsp;<br />&nbsp;<br />&nbsp;<br />
	<HR>
	&nbsp;<br />
	{$txt.pdf_form_hint}
{/block}