1. g10.1 Eligibility declaration by a disabled person

Please note there are penalties for making false declarations

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 our National Advice Service on 0845 010 9000 before signing the declaration.

I (full name)

of (address)

Tel e-mail:

declare that:

  • I am chronically sick or have a disabling condition by reason of: (give full and specific description of your

 

condition); _______________________________________________________ and that

  • I am receiving from: (name and address of supplier – see below)
    1 * the following goods which are being supplied to me for domestic or my personal use:
    (description of goods)
    2 * the following services to adapt goods to suit my condition:
    (description of services and goods)
    3 * the following services of installation, repair or maintenance of goods:
    (description of services and goods)
    4 * the following alterations to my private residence:
    (description of alteration)
    5 * the services of monitoring a personal alarm call system

and I claim relief from value added tax.



................................................................................ (Signature) ...................................................................... (Date)

====================================================================================

Supplier

I (full name): Freedom Custom Powerchairs Ltd

of (address) Chartwell House, 40, Chartwell Road,

Lancing Business Park, Lancing, West Sussex, BN15 8TY

Tel: 0843 289 6755, 07515 595 337 Fax: 0871 994 0012

am supplying to the person named above:

* the following goods:

Special Powerchair
for the personal use of the disabled person.



................................................................................ (Signature) .................................................................... (Date)

*Delete words not applicable

Note to Supplier:

You should keep this declaration for production to your VAT officer. The production of this declaration does not automatically justify the zero-rating of the supply. You must ensure that the goods and services you are supplying qualify for zero-rating.

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