VAT Exemption Form

I am receiving goods from HCE for an eligible chronically sick or disabled individual or for my domestic or personal use. OR: The goods will be made available through the below charity to a disabled person or persons for domestic or their personal use. I /We claim relief from VAT under Group 12 of Schedule 8 to the Act of 1994.

Please note there are custom and excise penalties for false declaration.

Once we have received your application, we will send you an email with instructions.

IMPORTANT: PLEASE DO NOT PLACE AN ORDER UNTIL WE HAVE EMAILED YOU STATING VAT EXEMPTION HAS BEEN APPROVED AND ACTIVATED ON YOUR ACCOUNT. WE WILL NOT ISSUE REFUNDS ON VAT IF AN ORDER IS PLACED BEFORE VAT EXEMPTION HAS BEEN APPROVED.

Your email address *

Your Full Name *

Name of Claimant/ Company *: Full Name of person for whom VAT Exemption is claimed

Address *: Address or name & address of charity

Description of Condition: Please give a full and specific description of your condition (charities leave blank)

Charity Number

Telephone *

Product(s) Required *: Let us know what products you wish to purchase.

: Declaration *
I declare that the claimant is chronically sick or has a disabling condition and that I have given correct information. If a charity, you have provided the correct charity number and you agree all information is correct.