Gift Aid Declaration Form

Gift Aid Declaration Form

Registered Charity 1201016 - Gift Aid# ZD19826
Name*

First NameLast NameSuffix
Address*

Street Address

Street Address Line 2

City

Postal CodeCountry
Email*
example@example.com
Please tick which applies.

(If you have not made a declaration you may still be able to claim on cash donations of £30 or less, for example from a collection)
I would like to Gift Aid any donations that I have made in the past 4 years and all future donations from the date of this declaration ORI would like to Gift Aid my donation today and any donations that I make in the future
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.
Please notify us if you: Would like to cancel this declaration. Change your name or home address. No longer pay sufficient tax on your income and/or Capital Gains
Note: 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.
Should be Empty: