VAT

EMAIL VAT EXEMPTION DECLARATION FORM
Please note there are penalties for making false declarations.

*indicates required fields

*YOUR FULL NAME (Disabled person):

*DATE OF BIRTH:

*FULL ADDRESS:

*POSTCODE:

*PHONE NUMBER:

*WHAT IS YOUR DISABILITY:

*ARE YOU DECLARING AS A PARENT ETC:

NO
PARENT
GUARDIAN
POWER OF ATTORNEY
CHARITY

IF SO WHAT IS YOUR NAME:

*DATE OF DECLARATION:

*YOUR EMAIL ADDRESS:

*HOW DID YOU HEAR ABOUT US / FIND US?:

CHARITY NUMBER:

NAME OF CHARITY:

If you are in any doubt as to whether you are eligible to receive goods or services zero rated for VAT you should consult notice 701/7 VAT reliefs for disabled people or contact the national advice service on 0845 010 9000 before signing this declaration.

You are declaring that you are chronically sick or have a disabling condition.

You are claiming relief of VAT on this purchase from HMS Mobility Solutions Ltd.

PLEASE NOTE there are penalties for making false declarations.

If you are declaring exemption on behalf of another person as parent / guardian / power of attorney please make sure you include your name.

Thank you

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