ࡱ> BDAq` @bjbjqPqP =::ddd84H $ h>#3 "  3H |   h .dp14^0AX## #@"AYm33X    d ddH  Name of Charity: Registered Address: Registered Charity Number: I am a UK taxpayer and authorise the charity to treat all donations I have made for the six years prior to this year and, all donations I may make from the date of this declaration until I notify you otherwise, as Gift Aid donations. Donor Declaration Title Forename(s) Lastname Address Post Code Spouse/Partner Joint Declaration (if appropriate) Title Forename(s) Lastname Address Post Code You must pay an amount of Income Tax and/or Capital Gains Tax at least equal to the tax that we reclaim on your donations in the appropriate tax year (currently 28p for each 1 you give). Donor Signature: . Date ..././.20. Spouse/Partner Signature: . Date .../..../.20. See overleaf for notes HMRC Notes If your declaration covers donations you may make in the future: Please notify the charity if you change your name or address while the declaration is still in force. You can cancel the declaration at any time by notifying the charity it will then not apply to donations you make on or after the date of cancellation or such later date as you specify. You must pay an amount of Income Tax and/or Capital Gains Tax at least equal to the tax that the charity reclaims on your donations in the appropriate tax year (currently 28p for each 1 you give). 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 (see note 1). If you pay tax at the higher rate you can claim further tax relief in your Self-Assessment tax return. If you are unsure whether your donations qualify for Gift Aid tax relief, ask the charity or, refer to the Inland Revenue help sheet IR65 available from your local tax office or on the HMRC web site.     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