Gift Aid declaration

Gift Aid Declaration

for past,present & future donations
ISLAMIC CULTURAL SOCIETY LUTON MOSQUE

Charity Name
1129781

Reg Charity No.
If you have made a donation or are a regular donor to the mosque then please complete this gift aid declaration. By doing this, the mosque will be able to claim back 25% of your donation amount from the government!

For example if you donate £100, then the mosque can claim back a further £25 from the government at no extra cost to you. This is because you have paid tax on your £100 donation which the mosque is able to claim back as a registered charity.
Donor Details
Title
Name

First Name or initial(s)Last Name
Full Home Address*

Street Address

Street Address Line 2

Town/ CityCounty

Postal Code
Telephone No.

Area CodePhone Number
Email*
example@example.com
Donation Amount (£)*
How often

WeeklyMonthlyYearlyOne-off
Method
Any Further Details
eg, Reference used for bank transfer
I confirm I have paid or will pay an amount of Income Tax and/or Capital Gains Tax for each tax year (6 April to 5 April) that is at least equal to the amount of tax that ‘Islamic Cultural Society Luton Mosque’ (Luton Central Mosque) will reclaim on my donations for that tax year. I understand that other taxes such as VAT and Council Tax do not qualify. I understand the charity will reclaim 25p of tax on every £1 that I give on or after 6 April 2008.*

I agree to the mosque claiming giftaid on all donations I have made in the last 4 years and going forward untilfurther notice.
Signature

Clear
Date

DayMonthYear
Date
Please notify the mosque if you:

Want to cancel this declaration

Change your name or home address

JazakAllah Khair for your continued support
Should be Empty:

Gift Aid Declaration

ISLAMIC CULTURAL SOCIETY LUTON MOSQUE

1129781

Donor Details