| GOODS AND SERVICES FOR DISABLED PERSONS: ELIGIBILITY DECLARATION BY A CHARITY
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| I | (name) (position) |
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| of the charity | (charity
name) (address) |
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| declare that the above named charity is receiving from: | Chariots
All Terrain Pushchairs VAT Reg. 750 7614 33 |
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| the following goods which are to be made available to a specific disabled person for domestic or their personal use: |
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| and I claim relief from value added tax under Group 14 of Schedule 5 to the Value Added Tax Act 1983 | ||
| (Signature) | (Date) | |