Gift Aid Declaration Form

Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email

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 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.