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Totals

Sub Total	£0.00
VAT	£0.00
Delivery total	£0.00
Discounts	-£0.00

Total cost	£0.00

Tick this box to claim VAT relief for yourself

I declare that I am chronically sick or disabled and buying from AgaMatrix goods which are being supplied for my domestic or personal use and are being paid for out of private or donated funds, and I claim that the supply is eligible for relief from VAT.

For

Disclaimer: There are severe penalties for making a false declaration. If you are in any doubt about your own eligibility or the eligibility of the goods or services you are buying, you should get advice from your local VAT office before signing this declaration.

Tick this box to claim VAT relief for someone else

I declare that the person named below is chronically sick or disabled and buying from AgaMatrix goods which are being supplied for their domestic or personal use and are being paid for out of private or donated funds, and I claim that the supply is eligible for relief from VAT.

Name*

Address Line 1*

Address Line 2

City*

Postcode*

Disclaimer: There are severe penalties for making a false declaration. If you are in any doubt about the users eligibility or the eligibility of the goods or services you are buying, you should get advice from your local VAT office before signing this declaration.

Tick this box to claim VAT relief for a charity

I declare that the Charity named below is buying goods from AgaMatrix which are goods of a kind described in the VAT Act 1994, Schedule 8, Group 12, item 2, and is paying for this supply with funds provided entirely by a charity or from voluntary contributions, and I claim that the supply is eligible for relief from VAT under Group 15, items 5 or 6 of the zero-rate Schedule to the VAT Act 1994.

Name*

Charity Name*

Charity No*

Disclaimer: There are severe penalties for making a false declaration. If you are in any doubt about the charity’s eligibility or the eligibility of the goods or services you are buying, you should get advice from your local VAT office before signing this declaration.

Success! Thank you for completing the VAT exemption form. VAT has successfully been removed from all eligible products.

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