VAT Exemption Application

You should complete this declaration if you are ‘chronically sick or disabled’ and the goods or services are for your own personal or domestic use.

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Customer Declaration

You should complete this declaration if you are ‘chronically sick or disabled’ and the goods or services are for your own personal or domestic use. A family member or carer can complete this on your behalf if you wish. You can find out more from the Helpsheets on the GOV.UK website or by telephoning the VAT Disabled Reliefs Helpline on Telephone: 0300 123 1073. HMRC staff cannot advise whether or not an individual is chronically sick or disabled.

A person is ‘chronically sick or disabled’ if he or she is a person:

- with a physical or mental impairment which has a long term and substantial adverse effect upon his or her ability to carry out everyday activities

- with a condition which the medical profession treats as a chronic sickness It does not include an elderly person who is not disabled or chronically sick or any person who is only temporarily disabled or incapacitated, such as with a broken limb.

- With a terminal illness

If you are unsure, you should seek guidance from your GP or other medical professional.

Please give this completed form back to the supplier. They will keep it with their VAT records.

Please do not send it to HMRC

FAQ

Can I claim VAT relief on behalf of someone else?

• Yes - but you will be required to put the claimants details on the VAT relief claim form.

Are all products subject to VAT relief?

• No - only products clearly identified are subject to VAT relief. You will be unable to purchase products which do not qualify for VAT relief under your account

Please note there are penalties for making false declarations

Are you completing this form for yourself or on behalf of someone else? *

Myself

On Behalf of someone else

I (Full Name) *

Please enter the full name of the person making this declaration

Who Are completing this on behalf of (Full Name)

Please enter the full name of the person with the disability / illness if the person named above is a Guardian and/or Charity Organisation completing on behalf of the individual

Address of the individual with the disability / chronic illness *

Please enter your full address

declare that they/I have the following disability or chronic sickness *

If applicant is a charity please enter your organisations details

Charity / Organisations name *

Registered Charity Number *

Account Creation

We require an email address to create your account, this email should belong to the person ordering the product, this allows us to cross reference this VAT exemption form against the order to verify the validity of the request, we will create your account manually after which you will receive an email containing your account details, user name and password

Email Address *

Please sign below (use mouse and left click, or use your finger if completing on a mobile device) *

Terms & Conditions *

I agree with the Terms & Conditions set out in the following link. I also agree to the Privacy Policy, specifically the section regarding VAT Exemption collection, use and storage of the supplied data. Privacy Policy & General Terms

I also Confirm that *

I am receiving the goods and/or services detailed overleaf, which are being supplied to myself / the named person (if completing on behalf of someone), for domestic or my personal use and i confirm that i am entitled to claim relief from VAT

Date Of VAT Exemption Application *

reCAPTCHA *

Name

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