Gift Aid

Name*

TitleFirst NameLast Name

Address*

Street Address

Street Address Line 2

City

Postal / Zip Code

Email*

example@example.com

Phone

In order to Gift Aid your donations, simply tick the box below. You’ll boost your donations by 25p for every £1 you donate.

I confirm I am a UK taxpayer and understand 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. Please treat as Gift Aid donations all qualifying gifts of money made today, in the last four years and in the future to Claire House, Charity no. 1004058 until I notify you otherwise. If you cannot commit to all time periods, please contact im@clairehouse.org.uk*

Yes, I am a UK taxpayer and wish to join the Gift Aid SchemeNo, I am not a UK taxpayer

1. You can cancel this Declaration at any time by notifying Claire House
2. If, in the future, your circumstances change and you no longer pay tax on your income and capital gains equal to the tax that the charity reclaims, you can cancel your Declaration.
3. If you pay tax at the higher rate you can claim further tax relief in your Self-Assessment Tax Return.
4. If you are unsure whether your donations qualify for Gift Aid tax relief, ask Claire House or refer to help sheet IR65 on the HMRC web site (www.hmrc.gov.uk).
5. Please notify Claire House if you change your name or address.