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Gift Aid declaration

I confirm that I am a UK Income or Capital Gains taxpayer. I have read this statement and want the Charity to reclaim tax on the donation detailed on this form, given on this date. 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. Please claim gift aid on gifts I have made/will make:

today

in the last four years

in the future