V.A.T. Exemption Declaration

 
Order Number:
Full Name of User:
Address Line 1:
Address Line 2:
Town:
County:
Postcode:

I declare that the above person is an eligible person under paragraph 1 of V.A.T. leaflet 701/7/86, that he/she is chronically sick or disabled and that he/she is receiving from General Medical, The General Medical Centre, Union Street, Aldershot, Hants. GU11 1EG, the following goods which are being supplied to him/her for his/her domestic or personal use:
Goods Being Purchased:
and I claim that the supply of these goods is eligible for relief from value added tax under group 14 of schedule 5 to the Value Added Tax Act 1983.

If you are completing this form on behalf of someone else, please print your name below and state your relationship to the eligible person.
Name:
Relationship:
There are severe penalties for making a false declaration. If you are in any doubt about your own eligibility or the eligibility of the goods you are buying, you should get advice from any local VAT office before signing this declaration.
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