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CLICK ON THE PRINT ICON TO PRINT THIS FORM |
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VAT Exemption Group 12 - Purchase by an individual for disabled self use: |
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(address)
The following: (description of goods)
Declare that: I am chronically sick or have a disabling condition by reason of (give full and specific description of your condition):
I am receiving from Morton Medical Ltd. , 329-339 Putney Bridge Road, London, SW15 2PG. United Kingdom. I declare that the goods are being supplied to me for domestic or my personal use.
Signed: Date: . If the individual is unable to sign because of their disability or illness a third party may sign on behalf of the named person. If you are a third party signing the above on behalf of someone else, please give you details below: Name Address
Relationship to the named person above? |
