Charity Gift Aid Declaration

Gift Aid of 25p for every £1 is reclaimed by the Charity from the tax you pay for the current year. Your address is needed to identify you as a current UK taxpayer.

Name of Charity: The Great Hospital

I am a UK taxpayer and 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.

Electronic Donation* £: (required)

Your Name (required)

Your Email (required)

Full Address (including Postcode) (required)

Date (required)

* The amount donated will be confirmed by the remittance advice from our payment service provider. Your name and email address must match.

Please notify the Charity if you:

• want to cancel this declaration

• change your name or home address

• no longer pay sufficient tax on your income and / or capital gains

If you pay Income Tax at the higher or additional rate and want to receive the additional tax relief
due to you, you must include all your Gift Aid donations on your self-assessment tax return or ask HM Revenue and Customs to adjust your tax code.