EmailMe Form - VAT EXEMPTION FORM

VAT EXEMPTION FORM
Vat Registration No. 874 2630 14

Name *

Please enter the name of the person that is claiming the Vat exemption

Prefix

Please enter the name of the person that is claiming the Vat exemption

First *

Please enter the name of the person that is claiming the Vat exemption

Last *

Please enter the name of the person that is claiming the Vat exemption

Suffix

Please enter the name of the person that is claiming the Vat exemption

Address *

Street Address *

Address Line 2

City *

State / Province / Region *

Postal / Zip Code *

Country *

Email *

Disclaimer:
I declare that i am an eligible person under para 1 of Vat leaflet 701/7,that i am suffering from eg. Arthritus,Stroke,Dementia *

Please enter condition suffering from

I claim that i am recieving from Rent Mobility Ltd, Goods that are being supplied to me for my own personel and domestic use, and i claim that the supply of these goods are eligible for Vat under group 14 of the zero rate shedule of the Vat act 1983 *

Please enter Name of person claiming Vat exemption

Item Purchased *

If you are completing this form on behalf of another person, please enter your full name

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