VAT EXEMPTION FORM

Please complete the following VAT EXEMPTION FORM in full:
I (Please provide you full name)
of (Please provide your full address, and postcode) declare that I am eligible under paragraph 1 of VAT EXEMPT leaflet 701/7/94.
and that I am suffering from: (please provide details of the condition)
I am receiving from Lazarus Mobility (UK) Limited the following goods which are being supplied to me for my personal use. (please tick to confirm)
Products being purchased: (Please enter product description)
Registered Charities:
(Please enter your charity name here)
 
Registered Charities:
(Please enter your charity number here)
 
I claim relief from VAT: (Please enter your name here to sign this declaration)
Your Email Address:
Contact Telephone Number:
Important Information: There are several penalties for making a false declaration. If you are in and doubt about your eligibility for VAT Exemption you should get advice from any local VAT office, before signing a declaration. VAT leaflet 701/7/86 is also available from your local VAT office.

Lazarus Mobility (UK) Limited
Registered in England and Wales - Company number: 6279164 VAT Number 901 4190 65
Registered Office: 10 Church Street, Paddock, Huddersfield, HD1 4TR

VAT EXEMPTION FORM