If I have ticked the box headed ‘Gift Aid? √’, I confirm that I am a UK Income or Capital Gains taxpayer. I have read this statement and want the charity or Community Amateur Sports Club (CASC) named above to reclaim tax on the donation detailed below, given on the date shown. I understand that if I pay less Income Tax / or Capital Gains tax in the current tax year than the amount of Gift Aid claimed on all of my donations it is my responsibility to pay any difference. I understand the charity will reclaim 25p of tax on every £1 that I have given.
Remember: please give your full name, home address and postcode, and tick Gift Aid, so that we can claim tax back on your donation.
| No. | Full namefirst name or initial, and surname | Home addressfirst line. Only needed if you tick Gift Aid. Not your work address, please. | Postcode | Amount£ | Date paid | Gift Aid?tick ✓ |
|---|---|---|---|---|---|---|
| 1 | ||||||
| 2 | ||||||
| 3 | ||||||
| 4 | ||||||
| 5 | ||||||
| 6 | ||||||
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| 9 | ||||||
| 10 | ||||||
| 11 | ||||||
| 12 | ||||||
| Total on this page | £ | |||||
If I have ticked the box headed ‘Gift Aid? √’, I confirm that I am a UK Income or Capital Gains taxpayer. I have read this statement and want the charity or Community Amateur Sports Club (CASC) named above to reclaim tax on the donation detailed below, given on the date shown. I understand that if I pay less Income Tax / or Capital Gains tax in the current tax year than the amount of Gift Aid claimed on all of my donations it is my responsibility to pay any difference. I understand the charity will reclaim 25p of tax on every £1 that I have given.
Remember: please give your full name, home address and postcode, and tick Gift Aid, so that we can claim tax back on your donation.
| No. | Full namefirst name or initial, and surname | Home addressfirst line. Only needed if you tick Gift Aid. Not your work address, please. | Postcode | Amount£ | Date paid | Gift Aid?tick ✓ |
|---|---|---|---|---|---|---|
| 13 | ||||||
| 14 | ||||||
| 15 | ||||||
| 16 | ||||||
| 17 | ||||||
| 18 | ||||||
| 19 | ||||||
| 20 | ||||||
| 21 | ||||||
| 22 | ||||||
| 23 | ||||||
| Total on this page | £ | |||||