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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 goods or services zero-rated for VAT you should consult Notice 701/7 Vat reliefs for disabled people or Contact the National Advice Service on 0845 010 9000 before making the declaration.

I (full name):

Of (address):


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

(Please give a full and specific description of your condition);


and that;

I am receiving from Able Life Products Ltd, Greensward House, 12 Brook Road, Rayleigh, Essex SS6 7UR

  • the following goods which are being supplied to me for my domestic and/or personal use.


Enter your full name here to confirm declaration:

Today's Date:

Please enter your email address:


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