VAT Relief Declaration Form
Note to customer 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. If you are unsure, you should seek guidance from your GP or other medical professional.
VAT
Name *
Please enter your name
Your answer
Address *
Your answer
Postcode *
Your answer
Phone *
Please, enter your phone number
Your answer
e-mail
Please, enter your email
Your answer
Condition *
I declare that I have the following disability or chronic sickness. I am receiving the goods and/or services from Marshall Mobility, which are being supplied to me for domestic or my personal use and I claim relief from VAT..........Please enter a long term condition
Your answer
Signature *
Please print your full name, this will be accepted as a electronic signature
Your answer
Date *
MM
/
DD
/
YYYY
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