VAT Disclaimer

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

First Name

Last Name

Phone

Address

Address Line 2 (optional)

City

County

Country

Postcode

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

Are YOU the USER and claiming VAT relief?

YES

User Details

First Name

Last Name

Address

Address Line 2 (optional)

City

County

Postcode

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:

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

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.