Terms and Conditions v2.3.1
1.1 What these terms cover. These are the terms and conditions on which we supply products and services to you. Our products and services include polymerise chain reaction (“PCR”) and Antibody IgG tests, referred to as “testing kits” within these terms and conditions. PCR testing only identifies whether a person is infected with the Covid -19 at the time of testing and is not 100% accurate. The supply of testing kits includes arranging for laboratory analysis and providing you with the test results. Additional terms relating to our supply of testing kits and associated service can be found within clause 8 of these terms.
1.2 Why you should read them. Please read these terms carefully before you submit your order to us. These terms tell you who we are, how we will provide products and services to you, how you and we may change or end the contract, what to do if there is a problem and other important information. If you think that there is a mistake in these terms, please contact us to discuss.
2.INFORMATION ABOUT US AND HOW TO CONTACT US
2.1 Who we are. We are VIVO clinic Manchester Ltd, trading as VIVO Shop, a company registered in England and Wales with company number 09721928. Our registered address is Harpal House 14 Holyhead Road, Handsworth, Birmingham, West Midlands, United Kingdom, B21 0LT
2.2 How to contact us. You can contact us by telephoning our customer service team at 0333 305 8486 or by writing to us at firstname.lastname@example.org or Harpal House 14 Holyhead Road, Handsworth, Birmingham, West Midlands, United Kingdom, B21 0LT
2.3 How we may contact you. If we have to contact you, we will do so by telephone or by writing to you at the email address or postal address you provided to us in your order.
2.4 “Writing” includes emails. When we use the words “writing” or “written” in these terms, this includes emails.
OUR CONTRACT WITH YOU
3.1 How we will accept your order. Where your order is placed on our website, our acceptance of your order will take place when payment is completed by you to us and authorised by your bank, at which point a contract will come into existence between you and us. Where you place your order in person at one of our clinics, our acceptance of your order takes place immediately, at which point a contract will come into existence between you and us
3.2 If we cannot accept your order. If we are unable to accept your order, we will inform you of this and will not charge you for the product. This might be because the product is out of stock, because of unexpected limits on our resources which we could not reasonably plan for, because we have identified an error in the price or description of the product, because of a change in regulations or because we are unable to meet a delivery deadline you have specified.
3.3 Your order number. We will assign an order number to your order and tell you what it is when we accept your order. It will help us if you can tell us the order number whenever you contact us about your order.
3.4 We only sell to the UK and Ireland. Our website is solely for the promotion of our products and services in the UK and Ireland. Unfortunately, we do not accept orders from or deliver to addresses outside the UK and Ireland.
3.5 We only sell to individuals over 18 years old. You may not order products and services from us if you are less than 18 years old.
OUR PRODUCTS AND SERVICES
4.1 Products may vary slightly from their pictures. The images of the products on our website are for illustrative purposes only. Although we have made every effort to display the colours accurately, we cannot guarantee that a device’s display of the colours accurately reflects the colour of the products. Your product may vary slightly from those images.
4.2 Product packaging may vary. The packaging of the product may vary from that shown in images on our website
5.YOUR RIGHTS TO MAKE CHANGES
5.1 If you wish to make a change to the product you have ordered, please contact us. We will let you know if the change is possible. If it is possible, we will let you know about any changes to the price of the product, the timing of supply or anything else which would be necessary as a result of your requested change and ask you to confirm whether you wish to go ahead with the change. If we cannot make the change or the consequences of making the change are unacceptable to you, you may want to end the contract (see clause 10 – Your rights to end the contract).
5.2 By placing an order, you agree that it is your responsibility to purchase the correct test to suit your needs and to ensure that you are suitable to undergo the test. If you are unsure which test you should select, you must speak to a qualified Medical Professional such as a doctor or your GP.
5.3 While we make every effort to ensure that the information we provide on our website is accurate, the rapidly changing landscape of testing and diagnostics during the pandemic means that changes or inaccuracies are possible. We take no responsibility for issues that arise from inaccurate information on our website, products, and travel information portal. We strongly recommend that you check with the UK government website and your travel provider for the latest information and that you ensure you are buying or booking the correct product or service for your requirements. If you believe you have discovered an inaccuracy anywhere on our site, please contact us before making a purchase or booking.
6.OUR RIGHTS TO MAKE CHANGES
6.1 Changes to the products and services. We may change the product to reflect changes in relevant laws and regulatory requirements.
7.VALIDATION OF PRODUCTS AND SERVICES
7.1 Validation of IgG antibody testing kits. The test is validated by the manufacturer when using its equipment and reagents for venous sampling. This is the blood that is drawn directly from the vein. Please be advised that capillary sampling, which is blood taken by means of finger-prick, is not validated by Public Health England and by the manufacturer of the test. This is validated by internal studies from our Government approved laboratory.
7.2 By agreeing to these Terms and Conditions, you confirm that you are aware that the IgG Antibody Test is only validated by Public Health England for venous samples and not capillary samples. Our Government approved laboratory has validated capillary samples for home sample collection kits. Venous sampling involves using a catheter to take a blood sample directly from the vein. The sample is most commonly taken from the inner crook of the elbow, between the upper and lower arm. Capillary sampling involves collecting a blood sample from a puncture, typically in the tip of the finger, on the heel or the earlobe. The blood will be collected from smaller blood vessels near the skin’s surface.
7.3 The IgG Antibody Home Sampling Kit and its components comply with CE markings.
8.PROVIDING THE PRODUCTS
8.1 Orders for testing kits. Orders placed for testing kits shall be processed:
8.1.1 within two working days of our acceptance of your order, subject to your order being placed before 12 pm on a working day;
8.1.2 within two working days beginning the next working day following receipt of your order, where your order is placed after 12 pm on a working day.
8.2 Tracking number for testing kits. Once your order for testing kits has been processed, you will receive a tracking number for your order. Your testing kit will be delivered within 48 hours of our communication of the tracking number.
8.3 When we will provide the products and delivery costs. Time for delivery of products (excluding testing kits) and cost of delivery of products will be as displayed to you on our website.
8.4 When you own goods. You own a product once we have received payment in full.
8.5 We are not responsible for delays outside our control. We are not responsible for any delay in the delivery of the product where such delay or non-delivery is attributable to Royal Mail or alternative carrier. If our supply of the products and services is delayed by an event outside our control of which we are aware, then we will contact you as soon as possible to let you know, and we will take steps to minimise the effect of the delay. Provided we do this, we will not be liable for delays caused by the event, but if there is a risk of substantial delay, you may contact us to end the contract in accordance with these terms and receive a refund for any products and services you have paid for but not received.
8.6 We are not responsible for delays in results. We are not responsible for delays in the provision of results arising due to the late posting of samples to the laboratory. If your sample is not received by the laboratory and you are able to provide us with proof of postage, we will send you a replacement testing kit free of charge.
8.7 Replacement of testing kits. If your testing kit is damaged on delivery, any components of the test are missing, or you require additional lancets or collection tubes, we will send you a replacement testing kit free of charge. If the pre-paid envelope is damaged or torn, we will send you a new one. Please do not send your sample in a damaged postage bag, as this poses a risk of contamination. Where the testing kit is damaged or lost by you, we will send you a replacement testing kit, for which we will charge an additional charge of £35.
9.YOUR USE OF TESTING KITS
9.1 How and when to collect your sample. You should ensure that:
9.1.1 You follow the instructions for collecting a sample as provided with the testing kit. You will also be entitled to a free pre-test consultation to help you use the testing kit correctly;
9.1.2 you must collect your sample and send it to the laboratory within 7 days following receipt of your testing kit and ensure it is sent to the laboratory on the same day as the sample is collected. If you do not, we may be unable to process your sample. A delay of a day or more between sample collection and postage to the laboratory could affect the laboratory’s ability to conduct the test and may affect your results; and
9.1.3 once you have collected your sample, you should send this to the laboratory in the pre-paid postage envelope provided with the testing kit, via a priority post box, as Royal Mail staff wear the appropriate personal protective equipment when collecting post from a priority post box. Should you return your sample by an alternative method and as a result, we do not have the relevant tracking information; we accept no liability if the sample is lost in the post or it does not otherwise reach the laboratory. If the pre-paid postage envelope that you receive is damaged, you can request a new one in accordance with clause 8.7.
184.108.40.206 some products are not suitable for transit with Royal Mail. In these cases, the correct information for returning your sample to us will be clearly stated on the product page and on the order confirmation email.
9.1.4 for in-clinic services, you are responsible for taking the swab sample yourself. This will be overseen by our practitioner to ensure the sample is taken in the correct manner
9.2 Where your sample will be processed. Laboratory results are provided by our partner labs. They are regulated by UKAS.
9.3 How you will receive your results.
9.4 We anticipate that within two working days of receipt of your sample by the laboratory, you will be sent an email with a link to your results. This timescale is an estimate only; the provision of results may be delayed due to the nature of the analysis required and the volume of samples submitted at the time your sample is received.
9.5 If the laboratory is unable to perform the test on your sample, for instance, if the blood has clotted or the quality of the sample has suffered in transit, we may send you a second testing kit. If the test cannot be performed because you have not followed the instructions correctly and you have not collected enough blood or DNA for the sample, you may have to pay a fee for us to send out a second testing kit.
9.6 Our contract with you for the provision of testing kits will terminate on the provision of the results to you.
10.YOUR RIGHTS TO END THE CONTRACT
10.1 You can always end your contract with us. Your rights when you end the contract will depend on whether there is anything wrong with the product and when you decide to end the contract or if you have given us express consent in order to perform a service/test by a set time and date and in doing so you have waived your right to a refund upon placing your order. Further detail is provided within the remainder of this clause and clause 11 regarding your rights to end the contract.
10.2 Ending the contract because of something we have done or are going to do. If you are ending a contract for a reason set out below, the contract will end immediately, and we will refund you in full for any products and services which have not been provided. The reasons are:
10.2.1 we have told you about an error in the price of the product or service you have ordered, and you do not wish to proceed;
10.2.2 there is a risk that supply of the products and/or services may be significantly delayed because of events outside our control; or
10.2.3 we have suspended supply of the products and/or services for technical reasons or notify you we are going to suspend them for technical reasons, in each case for a period of more than four weeks.
10.3 Exercising your right to change your mind (The Consumer Contracts (Information, Cancellation and Additional Charges) Regulations 2013 (“Regulations”). For most products and services bought online, you have a legal right to change your mind within 14 days and receive a refund. These rights are explained in more detail in these terms.
10.4 When you don’t have the right to change your mind. You do not have a right to change your mind in respect of:
10.4.1 products, once these have been unsealed after you receive them;
10.4.2 testing kits, once your sample has been sent to the laboratory;
10.4.3 any products which become mixed inseparably with other items after their delivery; and
10.4.4 any products and/or services which, subsequent to the processing of your order, are subject to a change in regulations.
10.4.5 You do not have a right to change your mind where you have come to our clinic in person and made an appointment/booking as this constitutes an on-premises contract as defined by the Regulations.
10.5 If your order has a test date that is less than 14 days from today’s date we will only be able to process your order if you waive your right to cancel pursuant to The Consumer Contracts (Information, Cancellation and Additional Charges) Regulations 2013. We strongly recommend that you take independent advice upon your rights before placing your order. By placing your order, you confirm that your right to cancel has been waived, and you are giving us an express request to carry out the service you have ordered. If your appointment cannot go ahead due to changes in regulations, government policies, changes to airline policies or changes to your own travel plans or anything out of our control, we may consider giving you a partial refund (taking into account costs which we have unavoidably incurred such as laboratory expenses and administrative fees) by way of a credit note.
11.HOW TO END THE CONTRACT WITH US (INCLUDING IF YOU HAVE CHANGED YOUR MIND)
11.1 Tell us you want to end the contract. To end the contract with us, please let us know in writing to email@example.com. Please provide your name, home address, details of the order and, where available, your phone number and email address.
11.2 Returning products after ending the contract. If you end the contract for any reason after products have been dispatched to you or you have received them, you must return them to us by tracked delivery. You must post them back to our head office. If you are exercising your right to change your mind, you must send off the goods within 14 days of telling us you wish to end the contract.
11.3 When we will pay the costs of return. We will pay the costs of return if the products are faulty or misdescribed or if you are ending the contract because we have told you of an upcoming change to the product or these terms, an error in pricing or description or a substantial delay in delivery due to events outside our control. In all other circumstances (including where you are exercising your right to change your mind), you must pay the costs of return.
11.4 How we will refund you. We will refund you the price you paid for the products and/or service by the method you used for payment if a refund is due. However, we may make deductions from the price, as described below. We may also use our discretion in offering a credit note as a refund where a refund would not normally have been due as per the terms of this agreement.
11.5 Deductions from refunds if you are exercising your right to change your mind. If you are exercising your right to change your mind, we may reduce your refund of the price of products (excluding delivery costs) to reflect any reduction in the value of the products resulting from your handling them in a way that would not be permitted in a shop, for example, where there is any damage to the products or where any components of the products are missing.
11.6 When your refund will be made. We will make any refunds due to you as soon as possible. If you are exercising your right to change your mind then:
11.6.1 Your refund will be made within 5 to 7 working days from the day on which we receive the product back from you.
11.6.2 In all other cases, your refund will be made within 5 to 7 working days of your telling us you have changed your mind.
12.OUR RIGHTS TO END THE CONTRACT
We may end the contract if you break it. We may end the contract for a product at any time by writing to you if you do not, within a reasonable time of us asking for it, provide us with information that is necessary for us to provide the products and/or services. For example, where you have ordered a testing kit, we may end the contract if you do not return a sample for analysis to the laboratory within seven days following delivery of the testing kit.
13.IF THERE IS A PROBLEM WITH THE PRODUCT
13.1 How to tell us about problems. If you have any questions or complaints about the product, please contact us. You can write to us at firstname.lastname@example.org or by post at the address in section 2.
13.2 Your obligation to return rejected products. If you wish to exercise your legal rights to reject products, you must post them back to us by tracked delivery. We will pay the costs of postage. The maximum refund for delivery costs will be the costs of delivery by the least expensive delivery method we offer. For example, if we offer delivery of a product within 3-5 days at one cost, but you choose to have the product delivered within 24 hours at a higher cost, then we will only refund what you would have paid for the cheaper delivery option.
PRICE AND PAYMENT
14.1 Where to find the price for the product. The price of the product will be the price indicated on the order pages when you placed your order. Testing kits are part of a medical service of diagnostics and therefore exclude VAT. We take reasonable care that the price of the product advised to you is correct. However, please see clause 14.2 for what happens if we discover an error in the price of the product you order.
14.2 What happens if we got the price wrong. It is always possible that, despite our best efforts, some of the products and/or services we sell may be incorrectly priced. We will normally check prices before accepting your order so that, where the product’s correct price at your order date is less than our stated price at your order date, we will charge the lower amount. If the product’s correct price at your order date is higher than the price stated to you, we will contact you for your instructions before we accept your order. If we accept and process your order where a pricing error is obvious and unmistakable and could reasonably have been recognised by you as a mispricing, we may end the contract, refund you any sums you have paid and require the return of any goods provided to you.
14.3 When you must pay and how you must pay. Orders must be paid for using a credit or debit card. Bank transfers and cheques will not be accepted. You must pay for the products and services before your order can be processed.
15.OUR RESPONSIBILITY FOR LOSS OR DAMAGE SUFFERED BY YOU
15.1 We are responsible to you for foreseeable loss and damage caused by us. If we fail to comply with these terms, we are responsible for loss or damage you suffer that is a foreseeable result of our breaking this contract or our failing to use reasonable care and skill, but we are not responsible for any loss or damage that is not foreseeable. Loss or damage is foreseeable if either it is obvious that it will happen or if, at the time the contract was made, both we and you knew it might happen, for example, if you discussed it with us during the sales process. We are only responsible for the value of the contract, which is the price you paid for the test.
15.2 We do not exclude or limit in any way our liability to you where it would be unlawful to do so. To the fullest extent permissible under applicable law, we disclaim any and all warranties of any kind, whether express or implied, in relation to the products and services. We do not exclude or limit in any way our liability to you where this includes liability for death or personal injury caused by our negligence or the negligence of our employees, agents or subcontractors; for fraud or fraudulent misrepresentation; for breach of your legal rights in relation to the products and services including the right to receive products and services which are: as described and match information we provided to you; of satisfactory quality; fit for any particular purpose made known to us; supplied with reasonable skill and care, and for defective products under the Consumer Protection Act 1987.
15.3 We do not warrant that the results that may be obtained from the use of the testing kit will be accurate or reliable. The use of the testing kit and your results are provided ‘as is’ and ‘as available’ for your use. You expressly agree that your use of, or inability to use, or incorrect use of, the testing kit is at your sole risk. We accept no liability for inconclusive or incorrect results wherever the sample has been collected, even if it is in one of our clinics.
15.4 We are not liable for any increase in the cost of products and/or services due to change in legislation or regulatory requirements. We shall not be responsible for any increase in the cost of a product resulting from changes to it required by law or regulation.
15.5 We are not liable for additional losses. Save for where it is unlawful to do so as set out under clause 15.2, we are not liable for any losses suffered by you as a result of using a product which is subsequently subject to regulatory change or where it is subsequently found to be inadequate or inaccurate as a result of research and development in sample collection and testing.
15.6 We are not liable for business losses. We only supply the products and services for domestic and private use. If you use the products and/or service for any commercial, business or re-sale purpose, we will have no liability to you for any loss of profit, loss of business, business interruption, or loss of business opportunity.
16.HOW WE MAY USE YOUR PERSONAL INFORMATION
16.2 If you submit personal information to us outside of the ordering process, you may be subject to additional terms, conditions, and policies, which will be explained at the time of submission.
17.OTHER IMPORTANT TERMS
17.1 Nobody else has any rights under this contract. This contract is between you and us. No other person shall have any rights to enforce any of its terms. You may only transfer your rights or your obligations under these terms to another person if we agree to this in writing.
17.2 If a court finds part of this contract illegal, the rest will continue in force. Each of the paragraphs of these terms operates separately. If any court or relevant authority decides that any of them are unlawful, the remaining paragraphs will remain in full force and effect.
17.3 Even if we delay in enforcing this contract, we can still enforce it later. If we do not immediately insist that you do anything you are required to do under these terms, or if we delay in taking steps against you in respect of your breaking this contract, that will not mean that you do not have to do those things and it will not prevent us taking steps against you at a later date. For example, if you miss a payment and we do not pursue a settlement, but we continue to provide the products and/or services, we can still require you to make the payment at a later date.
17.4 Which laws apply to this contract and where you may bring legal proceedings. These terms are governed by English law, and you can bring legal proceedings in respect of the products and services in the English courts. If you live in Scotland, you can bring legal proceedings in respect of the products and services in either the Scottish or the English courts. If you live in Northern Ireland, you can bring legal proceedings in respect of the products and services in either the Northern Irish or the English courts.
17.5 Antibody tests are not PCR tests and do not check for current infections.
17.6 Antibody and PCR tests are medical products/services and cannot be transferred.
17.7 If you cancel your appointment or your appointment can not go ahead due to changes in regulations, government policies, changes to airline policies or changes to your own travel plans or anything out of our control, a refund Will be issued by way of a credit voucher as our medical services are non-refundable.
17.8 If you cancel your appointment where you have a legal right to change your mind, a refund will be issued to you as outlined above in clause 11.4. Where you do not have a legal right to change your mind (for example, where your cooling off period has expired) and if your appointment can not go ahead due to changes in regulations, government policies, changes to airline policies or changes to your own travel plans or anything out of our control, we may consider giving you a partial refund by way of credit note so please do get in touch with us to discuss.
18.0 Please be advised that we cannot be held responsible for any financial losses that you may incur as a result of using any of our services, including PCR Travel Testing, and we cannot be held responsible if we have not delivered your result within the given time frames even if there has been human error in obtaining that result. In these cases, our liability to you will be limited to the value of the contract/order, which is the cost of the test you have purchased. If we are not able to deliver the service once a swab has been taken and are in breach of this contract, we will only be responsible for the value of the contract, which is the price of the test. No financial compensation will be offered for any financial or other losses suffered by you.
18.1 Occasionally, a sample may need to be re-run if the original results were inconclusive. In these cases, there is no additional charge. Refunds cannot be given for tests that require re-running.
18.3 Liability by us is excluded. To the fullest extent permitted by law, we exclude responsibility for every kind of liability arising under or in connection with this agreement, including but not limited to liability in contract, tort (including negligence), misrepresentation, restitution or otherwise. Nothing in this clause limits any liability which cannot legally be limited, including but not limited to (a) liability for death or personal injury caused by negligence; (b) fraud or fraudulent misrepresentation; and breach of the terms implied by section 12 of the Sale of Goods Act 1979 or section 2 of the Supply of Goods and Services Act 1982 (title and quiet possession). For the avoidance of doubt, we specifically exclude liability for any loss of your holiday/trip or the enjoyment to be derived from them.
18.4 Please be advised that We reserve the right to amend the cost of any of its products/services at any given time without notice. This is subject to the expense and availability of the raw components used for testing along with cost and demand for the services, which may result in a price increase or decrease depending on the above circumstances. VIVO shop will not refund any amount if a price change occurs after you have purchased a product/service as VIVO shop must pay its suppliers the relevant amount depending on the above factors.
18.5 By completing the purchase, you give to our laboratory permission to perform the PCR test as requested and discharge said laboratory, Vivo Clinic, and its associated companies from any false positives or false negatives that may be identified as a result of PCR testing, including inconclusive results or samples that have to be re-run.
18.7 The result you receive is for informational purposes only. What you choose to do with your results is your own responsibility. If you are obtaining a PCR test result for the purposes of travel, you acknowledge and understand that it is your responsibility to give the laboratory sufficient time to process the sample and obtain a result.
18.8 You understand that the laboratory processes samples Monday to Saturday between 9 am and 6 pm. You understand that you must give at least 48 hours for your sample to be processed once the lab receives this. You understand that all samples taken will be processed on the next working day, and you will receive your test result within 48 hours of the laboratory receiving the sample unless a priority service has been purchased.
18.9 You will not hold the laboratory, Vivo Clinic and its associated companies responsible if you miss your flight or if you are unable to board your flight in the event that your PCR test timeframe has expired.
18.10 You accept that it is your responsibility to provide correct and legible contact information on both the sample and the accompanying form. We expressly exclude liability for any losses arising out of your failure to comply with this clause.
18.11 We do not provide your passport number as a standard part of the service when you purchase a test certificate unless you contact the call centre by phone/email in order to request for this to be added. Fit to fly is defined as. FIT TO FLY CERTIFICATE THAT CONFIRMS A NEGATIVE RESULT ONLY CONFIRMS THAT AT THE TIME OF THE TEST BEING COMPLETED YOU MAY HAVE BEEN NEGATIVE OF COVID-19; IT DOES NOT ASSESS ANY OTHER HEALTH OR MEDICAL CONDITIONS.
18.12 We cannot hold appointment bookings if you arrive late, and no refunds can be given. You will need to rebook an appointment (subject to availability).
18.13 Any timescale for obtaining a result which we show is not a guarantee that the timescale will be adhered to (for example, same day services). We cannot provide any guarantee of timescale as we are reliant upon the postal system for the delivery of the sample, and this is outside of our control.
18.14 Please be advised that the money-back guarantee is only valid in the unlikely event that we are unable to deliver you a result within a specified timeframe.
18.14.1 A ‘result’ is deemed to be:
18.14.2 Positive – Covid-19 has been detected in the sample at the time of the sample.
18.14.3 Negative – Covid-19 has not been detected at the time of the sample.
18.14.4 Inconclusive – Neither a positive nor a negative result has been generated, but instead, an inconclusive result has been produced. Your sample must be re-run as a positive or negative result could not be provided during the first instance.
18.14.5 Please be advised that any of the above outcomes (positive, negative or inconclusive) are deemed to be a ‘result’, and therefore, a refund will not be issued. The guaranteed result for our same-day or next-day service can take up to 3am the following day as the labs can require time for the certificates to be generated.
18.14.6 The circumstances in which a refund will be issued are:
18.14.7 If we are unable to produce a positive, negative, or inconclusive result in the specified timeframes which will be limited to the value of the service purchased. This can be due to reasons such as the capacity of samples we are testing due to a high demand, technical errors in delivering the result within the timeframe and unforeseen circumstances outside of our control.
TEST TO RELEASE
19.00 You confirm that you have checked what your airline regulations are in regard to testing before travel.
20.00 Our samples for test and release are processed by our partnered laboratory who are registered on the Government approved lists for test to release.
20.01 You remain responsible for following government advice and keeping up to date with any regulatory changes related to test to release.
SCHEDULE 1 MODEL CANCELLATION FORM (Complete and return this form only if you wish to withdraw from the contract) To Vivo Shop I/We [*] hereby give notice that I/We [*] cancel my/our [*] contract of sale of the testing kit and results, Ordered on [*]/received on [*], Name of consumer(s), Address of consumer(s), Signature of consumer(s) (only if this form is notified on paper), Date [*] Delete as appropriate © Crown copyright 2013.