StandOut Gift Aid Declaration form

Gift Aid Declaration Form
Charity Name: StandOut Programmes

Charity Number: 1177813
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.*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please leave your email so we can get in touch to administer your gift aid declaration. This is not mandatory.
example@example.com
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. 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.
Signature*

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Please notify us if you:
1. Would like to cancel this declaration.
2. Change your name or home address.
3. 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:

Gift Aid Declaration Form