Gift aid declaration form

Gift aid declaration form
The Arc Church (charity number 1165652)
Full Given Name*

First NameLast Name
Preferred name*
Maiden name*
Which branch do you attend?*
Date*

DayMonthYear
Date
Email*
example@example.com
Phone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
I am a UK taxpayer and understand that if I pay less Income Tax and/or Capital Gains Tax in the current tax year than the amount of Gift Aid claimed on all my donations it is my responsibility to pay any difference.

If any are not a taxpayer you should cancel this declaration.

If in the future your circumstances change and you no longer pay sufficient tax, you can cancel your declaration. Please let us know any future changes in your details.
I agree
Donations i'd like to be treated as Gift aid donations (Tithes, Offering, Missions, 2020 vision and building funds)

TithesOfferingMissions2020 visionBuilding funds
I want to Gift Aid any donations made to The Arc now, in the future and in the past four years (but no earlier than 1 April 2016).
Gift aid start date*

DayMonthYear
Date
Gift aid end date (End date of employment)

DayMonthYear
Date
Signature

Clear
Should be Empty: