| SWIMFRIENDS |
|
GOODS
AND SERVICES FOR DISABLED PERSONS ELIGIBILITY DECLARATION BY A
CHARITY/INDIVIDUAL |
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|
| Tick
as appropriate |
| I
(full name) |
|
of (address) |
| .................................................................................................................................. |
| .................................................................................................................................. |
|
 |
declare
that the charity named above is receiving from: |
 |
declare
that I am substantially and permanently disabled by reason of: |
| |
................................................................................................................................ |
| |
and
I am receiving from:
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SWIMFRIENDS
TOPS HILL
KIRK IRETON,
KIRK IRETON
DE6 3JX
01332 842685 (Monday-Friday 9-18) FAX: 01629 822272
United Kingdom |
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|
 |
the
following goods are to be made available to a specific disabled
person or persons for domestic or their personal use |
|
 |
the
following services to adapt goods to suit the condition of a
disabled person to whom the goods are to be made available |
|
 |
the
following services of installation, repair of maintenance of goods |
|
| Description
of Goods/Services |
| ......................................................................................................................................................... |
| ......................................................................................................................................................... |
| ......................................................................................................................................................... |
| ......................................................................................................................................................... |
|
| and
I claim relief from value added tax under Group 12 of Schedule 8 to the
Value Added Tax Act 1994 |
| Signature: |
....................................................................................................................................... |
|
| Date: |
....................................................................................................................................... |
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NOTE TO THE 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. |
WARNING:
Section 62 of the VAT Act 1994 provides for severe
penalties for anyone who makes use of a document which thay know to be
false for the purpose of obtaining VAT relief. |