Gift Aid Declaration Form

Name(Required)

Title First Name Surname

Address(Required)

Street Address Address Line 2 City Postcode Country

Email(Required)

Phone

Please select one of the following options:(Required)

I want to Gift Aid any donations I make in the future or have made in the past 4 years to Helen & Douglas House. I AM a UK taxpayer and understand that if I pay less Income Tax and/or Capital Gains Tax than the amount of Gift Aid claimed on all my donations in that tax year it is my responsibility to pay any difference.

I am NOT a U.K. taxpayer.

Please contact us on 01865 799150 or [email protected] if you want to cancel this declaration, change your name or home address, or 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.

I am happy to receive further communications by email and SMS.

For more information about what we do with your data, including wealth profiling and data appending if you opt in to receiving email or SMS updates from us, please read our privacy policy at hdh.org.uk/supporter. You can opt-out of receiving this information, or having your data used in these ways, at any time by contacting us on [email protected] or 01865 799150.