VAT Declaration to Opus Energy Limited regarding premises for
Full or partial Qualifying Use
Business/Company Name
VAT Registration Number
(If applicable)
Opus Energy Limited
Royal Pavilion
2 Summerhouse Road
Northampton
NN3 6BJ
FOR OFFICE USE
Date Received
Site Reference Number
D
D
M
M
Y
Y
Y
Y
Premises Address
Postcode
Percentage of Supply on which Qualifying Use is claimed
(Please give whole numbers only)
Description of claim
(Please tick as applicable)
%
Domestic Use
Charitable non-business
Full name and job title of authorised signatory
Name: Job Title:
Signature: Date:
Declaration
I am authorised to sign this declaration. I certify that the information given above is correct and complete. I agree to notify Opus Energy Limited if there is any change to these circumstances. I understand that any incorrect information given may make me liable to a financial penalty under the terms of The Finance Act 1989.
NOTE
If the percentage for Qualifying Use changes, a new declaration form must be completed and submitted to Opus Energy Limited.
Opus Energy (Corporate) Limited · Company Reg No 5199937 ·
Registered Address · Lambourne House · 311-321 Banbury Road · Oxford · OX2 7JH
VAT No.: 818 2900 29
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