The respondents were trustees of the South African Red Cross Air Mercy Service Trust (the Trust), a non-profit organisation registered as a public benefit organisation (PBO) under the Income Tax Act and as a VAT vendor. The Trust provided aero-medical services (including flying doctor services, air ambulance, rescue services, and patient transfers) to provincial health departments under written agreements concluded since 2006. The provincial governments paid the Trust a monthly availability fee for aircraft and additional kilometre/hourly rates for flights undertaken. The Trust applied for a binding private VAT ruling, contending that payments received from provincial health departments qualified for VAT zero-rating under section 11(2)(n) of the VAT Act as they were 'deemed services' under section 8(5). The Commissioner ruled that these were actual services rendered under section 7(1)(a), not deemed services, and were subject to VAT at the standard rate of 14%. The Trust had previously paid VAT on remuneration received and claimed input tax deductions.