CMC Gift Aid Donation Form

Charity Gift Aid Declaration

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. We can also claim gift aid for previous and any future giving.

In order to Gift Aid your donation you must tick the box below*

I want to Gift Aid my donation of

£ amount* and any donations I make in the future or have made in the past 4 years to:

Name of Charity*

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

Title*

First name or initial(s)*

Surname*

Address*

Street Address

County

Post Code

Today's Date*

Date

I wish to receive updates on the development of the medical chair by the following means. I consent for my information to be stored for such purposes. *

Email*

example@example.com

Phone Number*

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.

*You may withdraw consent at any time with regard to receiving information about our work and fundraising activities. Contact us