Wellcat.org.uk

(please print this page)

Please complete and return this form to the following address:

Wellcat, 30 Quinton Road West, Quinton, Birmingham, B32 2QD

Donors Name:

Title:

Forenames:

Last Name:

Address:

Postcode:

I want the charity to treat:

*the enclosed donation of £………………as a Gift Aid donation.

*the donation/s of £………which I made on…………………

*all donations I make from the date of this declaration until I notify you otherwise as Gift Aid donations.

*all donations I have made for the six years prior to this year and all donations I make from the date of this declaration until I notify you otherwise, as Gift Aid donations.

*delete as appropriate

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 pound you give).

Date:

Signed:

Notes:
1. You can cancel this Declaration at any time by notifying the charity.
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 Assesment tax return.
4. If you are unsure if your donations qualify for Gift Aid tax relief, ask the charity. Or, refer to help sheet IR65 on the HMRC web site. (www.hmrc.gov.uk).
5. Please notify the charity if you change your name or address.