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VAT Relief Form for zero-rated goods

Please note there are penalties for making false declarations

For more information and guidelines on VAT Relief, please contact the HMRC Charities and VAT Helpline on 0300 123 1073 or visit HM Revenue & Customs. If you are in any doubt as to whether you are eligible for zero-rated VAT, you should consult your doctor before signing the declaration.

I (full name):  
Address:  
Email:    

Declare that:

I am receiving products from Care & Repair Leeds, 323 Roundhay Road, Leeds LS8 4HT, which are being supplied for my personal use and I claim relief from value added tax.

Details of chronic illness/disability:
 

Signature:  

Care & Repair complies with its obligations under the Data Protection Act 1998. By completing the order form (and as appropriate, the VAT relief certificate) you consent to Care & Repair Leeds recording and sharing the information provided only for the purposes of fulfilling this agreement.