VAT Exemption Form for Disabled Persons

Goods and Service for Disabled Persons: Eligibility Declaration by an individual.
I declare that I am chronically sick and disabled: (Please give a full and specific description of your condition) __________________________________________________________________________________________________________________________________________________________________________________________________________________

And that I am receiving from www.limekitchenandbathroom.co.uk the following goods which are being supplied to me for domestic or personal use (description of goods - please enter on the bottom of this form), and claim relief from value added tax under Group 14 of Schedule 5 to the Value Added Tax Act 1983. 

Signature: ____________________________________________ 

Print name: ___________________________________________

Address: ____________________________________________________________________________________________________________________________________________

Post Code: __________________   Telephone No: __________________________

If you are in doubt as to whether you are eligible to receive goods or services zero-rated for VAT, you should consult your local VAT office before signing this declaration.

WARNING: Section 39.2 of the VAT Act 1983 provides for severe penalties for anyone who makes use of a document which they know to the false for the purposes of obtaining VAT relief.

Please print off, sign and return either by e-mail or post to: 

Lime Kitchen and Bathroom
The Courtyard
Great Sarratt Hall Farm
Sarratt 
Herts. WD3 4PD

Description of goods: __________________________________________________________________________________________________________________________________________________________________________________________________________________