EmailMe Form - Eligibility declaration by a charity

I (full name of Charity) *

Charity registration number *

Address of Charity

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Declare that the charity named above is receiving from Care Shop, Unit B, Circle Court, Warren Bruce Road, Manchester, M17 1LB the following equipment which is being purchased using charitable funds for the purposes of medical or veterinary research, training, diagnosis or treatment:

Description of goods: *

And I claim relief from value added tax:

Name:

Date

DD / MM / YYYY