VAT Disclaimer Form

If you are eligible to be exempt from VAT (Value Added Tax) then this form must be completed

Name*

First Last

Email*

Phone*

Address

Address Address Line 2 City County Postal Code

Are YOU the USER and claiming VAT relief?*

YES
NO

Please ensure you have read and accept the terms by which you may claim VAT relief. You must have a long term ailment that will endure for at least 12 months.

You are entitled to claim VAT relief, even if you are not the user with the long term sickness or disability. You can do this by entering the details below

User Details

Name

First Last

Address

Address Address Line 2 City County Postal Code

And I claim relief from Value Added Tax under Group 12 schedule 8 to the Value Added Tax Act 1994*

And I claim relief from Value Added Tax under Group 12 schedule 8 to the Value Added Tax Act 1994

I state that I am receiving the following goods/services for my domestic or pleasure use:

Please enter what you are claiming the VAT on. This has to be items sourced from us

I state that I am chronically sick or disabled by reason of:*

Please ensure you enter a full description. Not just can't walk, or just legs or back problems etc

*

Please acknowledge that you have understood the terms and conditions under Group 12 schedule 8 to the Value Added Tax Act 1994

Note to the supplier

You must keep this declaration for production to your VAT office. The production of this certificate does not automatically authorize zero‐rating of the supply. You must also ensure that the goods and services you supply qualify for zero‐rating

Note to the customer

If you are in any doubt as to whether you are eligible to receive goods or services zero‐rated for VAT, you should consult your local tax office or view this link for more information.

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VAT Disclamer Form

VAT Disclaimer

VAT Disclaimer Form

User Details

Note to the supplier

Note to the customer

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