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VAT EXEMPTION FORM

Eligibility declaration for relief from Value Added Tax (VAT) by a disabled person or registered charity.

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 before signing this declaration.

I am claiming for myself.

I am claiming on behalf of someone else.

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Salutation*

Mr.

Mr.
Mrs
Ms
Miss
Dr.
Prof.
Other

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First name*

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Middle name

Last name*

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Mobile number*

Please provide a valid phone number, starting with +44. This field is required Please provide a valid phone number, starting with +44. Do not add any separators, like -, (), or blanks.

Street Address*

This field is required

Address Line 2

Post code*

This field is required Enter Zip code in correct format

City*

This field is required

Date of birth (DD/MM/YYYY) *

Mandatory fields are not filled

Wrong date format

Invalid date

* I am receiving from Abbott Laboratories Ltd, Abbott House, Vanwall Business Park, Vanwall Road, Maidenhead, SL6 4XE the following goods that are being supplied for personal use: Flash Glucose Monitoring system (including sensors). I claim relief from Value Added Tax.

* I declare that I suffer from Diabetes Mellitus or I am buying goods on behalf of someone who suffers from Diabetes Mellitus and who is over the age of 4.

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Author Edit Address Fragment URL here

Edit address

Please fill in all the required fields.

Required fields are marked with *

Required*

Salutation*

Salutation

Mr
Mrs
Miss
Dr
Prof
-

Mandatory fields are not filled

First name*

This field is required

Middle name

This field is required

Last name*

This field is required

Mobile number*

Please provide a valid phone number, starting with +44. This field is required Please provide a valid phone number, starting with +44. Do not add any separators, like -, (), or blanks.

Please verify your address

We found one address

To make sure your order is delivered to the correct address, we recommend selecting the suggested address. If this address is not correct, select your original entry and complete the address in the next step.

We found several addresses.

To make sure your order is delivered to the correct address, we recommend selecting one of the suggested addresses in the list. If none of these addresses are not correct, select your original entry and complete the address in the next step.

We found a large number of addresses.

No addresses found

We could not find an address based on the information you provided. To make sure your order is delivered to the correct address, please search again using more specific address information or select your original entry and complete the address in the next step.

Please fill in all the required fields.

Required fields are marked with *

Your address

Street Address*

This field is required

Address Line 2

Post code*

This field is required Enter Post code in correct format

City*

This field is required

County*

Select County

Bedfordshire
Berkshire
Bristol
Buckinghamshire
Cambridgeshire
Cheshire
Cornwall
Cumbria
Derbyshire
Devon
Dorset
Durham
East Sussex
Essex
Gloucestershire
Greater London
Greater Manchester
Hampshire
Herefordshire
Hertfordshire
Isle of Wight
Kent
Lancashire
Leicestershire
Lincolnshire
City of London
Merseyside
Norfolk
Northamptonshire
Northumberland
North Yorkshire
Nottinghamshire
Oxfordshire
Rutland
Shropshire
Somerset
South Yorkshire
Staffordshire
Suffolk
Surrey
Tyne and Wear
Warwickshire
West Midlands
West Sussex
West Yorkshire
Wiltshire
Worcestershire
Yorkshire, East Riding

This is a required field.

Country*

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Name of the address*

This field is required

Something went wrong saving your address

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We are sorry, but you cannot add more addresses

Your address book is full

We are sorry, but you have reached the limit of addresses in your account and can't add new ones. Please try editing existing addresses or go to My Account to delete the ones you don't use.

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Required*

Salutation*

Salutation

Mr.
Mrs
Ms
Miss
Dr
Prof
-

Select a title

First name*

This field is required Invalid Format/Text limit exceeded

Middle name

Last name*

This field is required Invalid format/Text limit exceeded

Mobile number*

Please provide a valid phone number, starting with +353. This field is required Please provide a valid phone number, starting with +353.

Please verify your address

We found one address

We found several addresses.

We found a large number of addresses.

No addresses found

Please fill in all the required fields.

Required fields are marked with *

Please enter Eircode and address

Please fill in all the required fields.

Required fields are marked with *

Eircode*

This field is required Enter Eircode in correct format

Street Address*

Plase add a valid street and number. This field is required No special characters allowed. Please add the address without any special characters. The maximum amount of allowed characters is 35.

Please complete your address

Address Line 2

No special characters allowed. Please add the address line 2 without any special characters. The maximum amount of allowed characters is 35.

County*

County

Carlow
Cavan
Clare
Co. Dublin
Co. Dublin North
Co. Dublin South
Co. Dublin West
Cork
Donegal
Dublin 1
Dublin 2
Dublin 3
Dublin 4
Dublin 5
Dublin 6
Dublin 6 W
Dublin 7
Dublin 8
Dublin 9
Dublin 10
Dublin 11
Dublin 12
Dublin 13
Dublin 14
Dublin 15
Dublin 16
Dublin 17
Dublin 18
Dublin 19
Dublin 20
Dublin 22
Dublin 24
Galway
Kerry
Keldare
Kilkenny
Laois
Leitrim
Limerick
Longford
Louth
Mayo
Meath
Monaghan
Offaly
Roscommon
Sligo
Tipperary
Waterford
Westmeath
Wexford
Wicklow

This field is required.

City*

City is required Text limit exceeded

Country*

Name of the address*

Name of address is required Name of address must be no longer than 15 characters

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Author Add a new address minimum form fields fragment url here

Add new address

Please fill in all the required fields.

Required fields are marked with *

Required*

Salutation*

Salutation

Mr
Mrs
Miss
Dr
Prof
-

Mandatory fields are not filled

First name*

This field is required

Middle name

This field is required

Last name*

This field is required

Mobile number*

Please provide a valid phone number, starting with +44. This field is required Please provide a valid phone number, starting with +44. Do not add any separators, like -, (), or blanks.

Please verify your address

We found one address

We found several addresses.

We found a large number of addresses.

No addresses found

Please fill in all the required fields.

Required fields are marked with *

Your address

Street Address*

This field is required

Address Line 2

Post code*

This field is required Enter Post code in correct format

City*

This field is required

County*

Select County

Bedfordshire
Berkshire
Bristol
Buckinghamshire
Cambridgeshire
Cheshire
Cornwall
Cumbria
Derbyshire
Devon
Dorset
Durham
East Sussex
Essex
Gloucestershire
Greater London
Greater Manchester
Hampshire
Herefordshire
Hertfordshire
Isle of Wight
Kent
Lancashire
Leicestershire
Lincolnshire
City of London
Merseyside
Norfolk
Northamptonshire
Northumberland
North Yorkshire
Nottinghamshire
Oxfordshire
Rutland
Shropshire
Somerset
South Yorkshire
Staffordshire
Suffolk
Surrey
Tyne and Wear
Warwickshire
West Midlands
West Sussex
West Yorkshire
Wiltshire
Worcestershire
Yorkshire, East Riding

This is a required field.

Country*

This field is required

Name of the address*

This field is required

Something went wrong saving your address

Please try again

We are sorry, but you cannot add more addresses

Your address book is full

We are sorry, but you have reached the limit of addresses in your account and can't add new ones. Please try editing existing addresses or go to My Account to delete the ones you don't use.

Go to My Account

Author Add a new address full form fields fragment url here

Add new address

Please fill in all the required fields.

Required fields are marked with *

Required*

Salutation*

Salutation

Mr
Mrs
Miss
Dr
Prof
-

Mandatory fields are not filled

First name*

This field is required

Middle name

This field is required

Last name*

This field is required

Mobile number*

Please provide a valid phone number, starting with +44. This field is required Please provide a valid phone number, starting with +44. Do not add any separators, like -, (), or blanks.

Please verify your address

We found one address

We found several addresses.

We found a large number of addresses.

No addresses found

Please fill in all the required fields.

Required fields are marked with *

Your address

Street Address*

This field is required

Address Line 2

Post code*

This field is required Enter Post code in correct format

City*

This field is required

County*

Select County

Bedfordshire
Berkshire
Bristol
Buckinghamshire
Cambridgeshire
Cheshire
Cornwall
Cumbria
Derbyshire
Devon
Dorset
Durham
East Sussex
Essex
Gloucestershire
Greater London
Greater Manchester
Hampshire
Herefordshire
Hertfordshire
Isle of Wight
Kent
Lancashire
Leicestershire
Lincolnshire
City of London
Merseyside
Norfolk
Northamptonshire
Northumberland
North Yorkshire
Nottinghamshire
Oxfordshire
Rutland
Shropshire
Somerset
South Yorkshire
Staffordshire
Suffolk
Surrey
Tyne and Wear
Warwickshire
West Midlands
West Sussex
West Yorkshire
Wiltshire
Worcestershire
Yorkshire, East Riding

This is a required field.

Country*

This field is required

Name of the address*

This field is required

Something went wrong saving your address

Please try again

We are sorry, but you cannot add more addresses

Your address book is full

We are sorry, but you have reached the limit of addresses in your account and can't add new ones. Please try editing existing addresses or go to My Account to delete the ones you don't use.

Go to My Account

Order Details

Edit Address

We found several addresses.

We found a large number of addresses.

Your address

We are sorry, but you cannot add more addresses

We found several addresses.

We found a large number of addresses.

Please enter Eircode and address

Please complete your address

Can't find the right address?

We are sorry, but you cannot add more addresses

We found several addresses.

We found a large number of addresses.

Your address

We are sorry, but you cannot add more addresses

We found several addresses.

We found a large number of addresses.

Your address

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Welcome, ${name}!

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VAT EXEMPTION FORM

Edit Address

Edit address

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We found several addresses.

We found a large number of addresses.

Your address

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Add new address

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We found several addresses.

We found a large number of addresses.

Please enter Eircode and address

Please complete your address

Can't find the right address?

We are sorry, but you cannot add more addresses

Add new address

Please verify your address

We found several addresses.

We found a large number of addresses.

Your address

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Add new address

Please verify your address

We found several addresses.

We found a large number of addresses.

Your address

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Welcome, ${name}!

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Edit address

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Add new address

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Edit address

Add new address

Add new address

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VAT EXEMPTION FORM

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