Please treat as Gift Aid donations and all qualifying gifts of money made
    todaypast four yearsin the future



    Please tick all boxes that apply



    I am a UK taxpayer and I confirm I have paid or will pay an amount of Income Tax and/or Capital Gains Tax for each tax year (6 April to 5 April) that is at least equal to the amount of tax that all the charities or Community Amateur Sports Clubs (CASCs) that I donate to will reclaim on my gifts for that tax year. I 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.



    Name:


    Signature:


    Date:


    Postal Address:


    Postcode:


    Email address: