VAT Exemption Form

If you are purchasing a product which is subject to VAT exemption, you must complete the form below to confirm your eligibility.
More information about VAT exemption

Your Name

Your Email

Telephone

Address Line 1

Address Line 2

Address Line 3

Town or City

Postcode

Todays Date (dd/mm/yyyy)

Declare That: I am Chronically Sick or have a Disabling Condition by reason of: * *

Product/Service you wish to purchase *

Checkboxes *

I am receiving goods/services from Mobility Solutions for an eligible chronically sick or disabled person or for my domestic or personal use.

Checkboxes (copy) *

I agree that my details are going to be collected.