VAT Exemption Form

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 Notice 701/7 VAT reliefs for disabled people or contact the HMRC National Advice Service on 0300 200 3700 before signing the declaration.

Date

First Name

Last Name

Postcode

Your Disabling Medical Condition

Goods or Parts Supplied

Signature