Climate Change Levy Supplier Certificate
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1Climate Change Levy supplier certificate
When to use this form
Do not use this form to claim the VAT reduced rate.
Use this form to claim relief against the main rates of Climate
If you need further help or advice go to hmrc.gov.uk or phone
Change Levy (CCL). Your supplier is legally obliged to receive this
the Excise Helpline on 0845 010 9000.
certificate before administering any relief. You need to complete
Fill the form in online then print it off to sign and date
a separate form for each taxable commodity.
the declaration.
Qualifying business and relief claimed
Name of qualifying business
Gas meter point reference number*
1
5
As shown on your energy bill or invoice
Address of qualifying business
2
Identify one commodity on which relief is claimed
6
Tick one box only
Gas
Electricity
LPG
Solid fuel
Postcode
Date from which relief is to be applied DD MM YYYY
7
You must complete a separate certificate for each supplier
and commodity on which you wish to claim relief.
Account reference number*
3
Percentage of supplies eligible for relief from CCL
8
This is the number shown on your energy bill or invoice
Take this from box 8b on your PP10 Climate Change Levy
Relief supporting analysis
%
Energy supplier’s name
Electricity meter supply number*
9
4
This is the number shown on your energy bill or invoice
*If you have more than one reference number
S
for the same commodity from the same supplier,
write them on the back of this certificate and
tick this box
Declaration
If you don’t give complete and accurate information on this certificate you may receive a financial penalty. If HMRC
impose a penalty you have the right to appeal.
I declare that the information I have given on this form is complete and correct.
10
Full name of responsible person within the business
Date DD MM YYYY
Signature
Phone number
What to do next
Do not send a copy of this certificate to HMRC.
Once you have completed the form, you must:
Your rights and obligations
• print the form, sign and date the declaration
Your Charter explains what you can expect from us and what we
•
keep a copy for your own record, and
expect from you. For more information go to hmrc.gov.uk/charter
•
send it to your supplier.
PP11
Page 1
HMRC 02/13
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