VAT ZERO RATING CERTIFICATE
GOODS AND SERVICES FOR DISABLED PERSONS
ELIGIBILITY DECLARATION BY AN INDIVIDUAL

NAME ..................................................................................................................................

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ADDRESS

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.......................................................................................................

.......................................................................................................

Post Code ..................................

 I declare that I am chronically sick or disabled by reason of:

.............................................................................................................................................

.............................................................................................................................................

.............................................................................................................................................

and that I am receiving from:

Premier Service and Installation  

Unit P Little Moor Lane, Loughborough, Leics LE11 1SF

the following services of repair and maintenance of goods:

.............................................................................................................................................

.............................................................................................................................................

.............................................................................................................................................

as per recommendation by:

.............................................................................................................

and that I claim relief from Value Added Tax under Group 12 of Schedule 8 to the Value Added Tax Act 1994

Signed .......................................................................................................

Date  .........................................20......... 

NOTE TO SUPPLIER
You must keep this declaration for production to your VAT office.  The production of this Certificate does not automatically authorise the zero rating of the supply.  You must also ensure the goods and services you are supplying qualify for zero rating.

Warning: Section 72.3 of the VAT Act 1994 provides for severe penalties for anyone who makes use of a document which they know to be false for the purposes of obtaining VAT relief.

NOTE TO CUSTOMER
If you are in any doubt as to whether you are eligible to receive goods or services zero rated for VAT, you should consult your local VAT office before signing the declaration