Gift Aid Declaration Form

Name(Required)

Title First Name Surname

Address(Required)

Street Address Address Line 2 City Postcode Country

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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.

We may stay in touch with you by post and phone with news from the hospice, and information about events you might be interested in and other ways your fundraising can support terminally ill children. If you would like us to contact you by email and/or text message, please tick the box below

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

We take your privacy seriously. For more information about what we do with your data, please read our privacy policy at www.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.