Deaf Awareness Technology 16 Furzey Road, Upton, Poole, Dorset, BH16 5RW.
Tel: +44 (0)1202 682795
email: sales@deafawarenesstechnology.co.uk

PLEASE PRINT THIS PAGE, FILL IN THE DETAILS AND RETURN IT TO US.

Product                             Unit Price   Quantity     Total £

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Total Price (Pounds Sterling)      £__________

Method of payment:
(__)Cheque,(__)Post orders, PayPal(__).

Address.......................................................................

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       ..................................Post Code............................

Email address.................................................................

Tel Number.......................  Fax Number.................................

Mobile Number......................................(optional)

UK RESIDENTS ONLY
VAT Exemption Form.  
PLEASE COMPLETE THIS SECTION TO OBTAIN VAT REFUND, IF ELIGIBLE.

Aids for handicapped persons-supply to an individual.

Title.............Full name...................................................
Address.......................................................................
..............................................................................
County.......................Post Code........................................

I declare that I am eligible person under paragraph 1 of leaflet 701/7/86, that I am 
handicapped by a hearing disability and that I am receiving from Deaf Awareness Technology,
16 Furzey Road, Upton, Poole, Dorset, BH16 5RW the items on the attached order form which 
are being supplied to me for my domestic or personal use and I claim that the supply of 
these goods is eligible for relief from Value Added Tax under Group 14 of the Zero Rated 
Schedule to the Value Added Tax Act 1983.

Signature...........................Date.............

THERE ARE SEVERE PENALTIES FOR MAKING A FALSE DECLARATION. IF YOU ARE IN ANY DOUBT ABOUT 
YOUR OWN ELIGIBILITY OF THE GOODS YOU ARE BUYING, YOU SHOULD GET ADVICE FROM ANY LOCAL 
VAT OFFICE BEFORE SIGNING THIS DECLARATION.