VAT Relief Form

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* 1. Are you filling out this form for yourself or for someone else?

For myself

For someone else

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* 2. What is your (or the person you're claiming for's) full name?

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* 3. Please enter your (or the person you're claiming for's) address

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* 4. What is the medical condition or disability that qualifies you (or the person you're claiming for's) for VAT relief?

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* 5. Please confirm the following:

I consent to this data being used to assess my (or the person you're claiming for's) eligibility for VAT relief

I declare these goods are for my own (or the person you're claiming for's) personal or domestic use