Offline Donation Form

Offline Donation Form

Please fill out this form for completed donations
Specify Donation*
Select Donation Frequency*
Enter Donation Amount
Donation Appeal*
Choose the Event or Donation Appeal
How was the payment processed*
Please specify*
Payment Processing Date

DayMonthYear
DD-MM-YYYY
Payment Slip Number (if applicable)
Payment Reference / Notes
Please share any additional payment information

Enter Donor Information
Check for anonymous donations
Company Name (if applicable)
Name*

First NameLast Name
Email*
example@example.com
Phone Number

Country CodeArea CodePhone Number
Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Reclaim Gift Aid

Add 25% more to your donation at no cost to you.
If you are a UK taxpayer and you select to 'Gift Aid' your donation will make it worth more to us. Please tick the box below to confirm that you have read the Gift Aid Conditions below, and that you are eligible to 'Gift Aid' your donation and wish to do so.
*GIFT AID CONDITIONS

I confirm that I am a UK Income or Capital Gains Tax payer and want Human Concern UK to reclaim the tax as Gift Aid on this donation, any previous donations for the last 4 years and any future donations until I notify otherwise.

I understand that Gift Aid is reclaimed by the charity from the tax I pay for the current year and 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.

I understand that other taxes such as VAT and Council Tax do not qualify.

I understand that the reclaimed tax will be used towards the administration cost of the charity and that I must inform the charity if I want to cancel the declaration, change my name or address or no longer pay sufficient tax.
Gift Aid Declaration Type
Donor Contact Preferences*
The donor opted in for
What prompted this donation?*
Please confirm by signing that the donation payment was collected successfully*

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