Certificate of Exemption from Value Added Tax

Order Number
Certificate of Exemption from Value Added Tax
Please note there are penalties for making false declarations
If you are in 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.
Full Name
Address
I 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 Jeff Gosling Hand Controls Ltd, Unit 3 Hollingworth Court, 264 Stockport Road West, Bredbury, Stockport, Cheshire, SK6 2AN

The following goods which are being supplied to me for domestic or personal use:
Products
Declaration:
E-mail
Should be Empty: