VAT Exemption Form
Please complete this form so that you can receive VAT Relief for your MobilityPlus wheelchair.
Name of purchaser
(if you are buying for someone else)
Name of the person eligible for VAT relief.
Address of the person eligible for VAT relief.
State / Province / Region
Postal / Zip Code
Contact phone number of purchaser
Please state illness (or charity number) qualifying you for VAT Relief
For VAT purposes, you qualify for VAT Relief if you’re disabled or have a long-term illness.
Date of purchase
I am receiving the goods from MobilityPlus Wheelchairs and they are being supplied for domestic or personal use.
Please fill in your name to sign this as a true statement.