Charity Gift Aid Declaration - Thank you for your donation!

Charity Gift Aid Declaration - Thank you for your donation!

Boost your donation by 25p of Gift Aid for every £1 you donate
Gift Aid is reclaimed by the charity from the tax you pay for the current tax year. Your address is needed to identify you as a current UK taxpayer.
In order to Gift Aid your donation you must tick the box below:*

I want to Gift Aid my donation to Dementia Active (Charity no. 1195246). 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.
Donation amount in £'s and pence.
How did you make this donation?

Paypal giving fundBank transfer to CAF BankOur Online storeJustGivingOther
Date the donation was made*

MonthDayYear
Date
If you haven't made a donation yet, you can click here, and then return to this form
My Details
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please notify the charity if you:

* want to cancel this declaration
* change your name or home address
* no longer pay sufficient tax on your income and/or capital gains.

If you pay Income Tax at the higher or additional rate and want to receive the additional tax relief due to you, you must include all your Gift Aid donations on your Self-Assessment tax return or ask HM Revenue and Customs to adjust your tax code.
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