Eligibility declaration by a disabled person

Please note there are penalties for making false declarations

If you are in any doubt as to whether you are eligible to receive good or services zero-rated for VAT you should consult Notice 701/7 VAT relief’s for disabled people or contact the National Advice Service on 0845 010 9000 before signing the declaration.

    I (Full name)

    Of (address)

    Declare that:
    I am chronically sick or have a disability condition by reason of: Diabetes; and that
    I am receiving medical devices from: Cambridge Sensors Ltd, Unit 9 & 10 Cardinal Park, Godmanchester, Cambridgeshire, PE29 2XG

    The following goods which are being supplied to me for domestic or personal use are:

    By selecting this box you declare that the information provided is correct