Self Employed Declaration Form

A.M.E Disabilty Consultants. 90 Longbridge Road , Barking, ESSEX , IG11 8SF Tel: 020 8507 8841 Fax: 020 8507 9650

We need confirmation for our records that you are self-employed and responsible for your own tax and national insurance. Please complete and submit the form below.

I confirm that I am self-employed and take responsibility for my own tax and national insurance
My schedule D number is:	This is the 10 digit self-assessment reference number found at the top of personal tax returns
Name:
Date:
Email Address: