Vat Zero Rating Certificate
Aids for Disabled Persons: Supplies to Individuals
I (full names)
of (address)
declare that:
l I am an eligible person under section 4 of VAT Leaflet 701/7 (2002) and that I am suffering from:
Description of illness
l and that I am receiving from:
Stannah Lift Services LtdWatt CloseEast PortwayAndoverHampshireSP10 3SD
Purchase, Service, Repairs or Maintenance of a Stairlift/Lift/Mobility Aid and I claim that the supply of thesegoods or services is eligible for relief from value added tax under Group 12 of Schedule 8 of the Zero RatedSchedule to the Value Added Tax Act 1994.
Signature Date
Please Sign This Form And Post By Return
There are severe penalties for making a false declaration. If you are in any doubt about your own eligibilityof the goods or services you are buying, you should get advice from any local VAT office before signing thisdeclaration.
It is essential that we receive this completed form in order that we can avoid charging you VAT for the aboveproducts and services.
Supplier DeclarationStannah Lift Services Limited is supplying the above goods and services for the use by a disabled person.
(Authorised signatory of the supplier) Date
Data Protection Act 1998:This form will be retained in its physical form or as a digital image by the company, as data controller, as evidenceof your claim for zero rating as required by VAT legislation. It will only be provided for review by HM Customsand Excise at their request. Confirmation of any change of circumstances or use of the qualifying product willbe undertaken every three years by the data controller. A full copy of the company’s data protection policy maybe obtained from the Company Secretary, Stannah Lift Services Limited, Watt Close, East Portway, AndoverSP10 3SD.
04/11/F124A
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