Gift Aid Declaration Form

Gift Aid Declaration Form

for giving to St Mary's Church Bloxham (Registered Charity Number 1129237)
Name*

First NameLast Name
Address*

Street Address

Address Line 2

TownCounty

Post Code
Email
example@example.com
Date*

DayMonthYear
Date
Please select one option below*

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 declarationI would like to Gift Aid my donation today and any donations that I make in the future
Gift Aid 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.
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.
We will keep your data safe and only use this to process your gift aid information and to address any queries. See our website for our full privacy policy.
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