Lightweight Wheelchairs, Rollators, Tri walkers, Walking Frames, Scooters & more.

EBAY VAT EXEMPTION DECLARATION FORM (8 easy items)

Eligibility declaration by a disabled person

UGO LTD

32,Camborne Avenue

Aylesbury, Buckinghamshire

HP21 7DX, United Kingdom

VAT #: GB 835 0186 39

1)

I

(Full Name of person for whom VAT Exemption is claimed)

2A)

eBay username:

(Please enter the eBay username you made the your purchase with)

B)

Item Purchased:

C)

Date Purchased:

3)

Of

(Address or name & address of charity)

4)

Declare that:

I am chronically sick or have a disabling condition by reason of:

I am receiving goods from Ugo Limited for an eligible chronically sick or disabled individual or for my domestic or personal use.

OR:

The goods will be made available through the above charity to a disabled person or persons for domestic or their personal use, and I/we claim relief from value added tax.

5)

Type your full name:

(Your typed name is your electronic signature)

6)

Today's Date:

7)

Your E-mail Address:

(We will send a copy of the completed form to this email address for your records)

8)

Telephone: