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VAT Exemption Declaration Form

Please complete all sections that are required. Note: there are penalties for making false declarations. If you are in any doubt as to whether you (or the person for whom the goods are intended) are eligible to receive goods zero rated for VAT, contact the National Advice Service on 0845 302 0203 or consult notice 701/7 VAT Reliefs for disabled people before submitting this form. Please note that a person doesn't need to be registered with HMRC to claim the VAT relief.

By filling in the declaration form, submitting, and purchasing 0% VAT products, you are claiming exemption from Value Added Tax (VAT) under Group 14 of Schedule 5 to the Value Added Tax Act 1983.

You are only required to fill in this declaration once. If you wish to purchase more than one 0% VAT product, you may do so without completing the declaration form again.

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* Required information.
I (Claimant's Name) *
Claimant's Door Number or Name *
Claimant's Road / Street Name *
Claimant's City
Claimant's Postcode *
Daytime Contact Number *
Email Address *
I declare that I am chronically sick or disabled by the condition of: (please specify your medical condition, giving details if appropriate) *