I enclose a cheque made payable to
Hamlin Fistula UK for the sum of £.
Gift
Aid Declaration
I
confirm that (choose one only):
I wish this and
any future contributions donated to Hamlin Fistula UK to be treated as Gift Aid donations under the new Gift Aid Scheme. I am a UK taxpayer and pay an amount of Income Tax and/or Capital Gains Tax at
least equal to the tax that can be reclaimed on my donation. Please accept
this declaration for any future donations I may make to this charity. I will advise
you if there are any changes to this status.
I am not a UK taxpayer.
All
donations will be acknowledged directly to you by this charity.
Name
(in capitals):
Address:
Address:
Address:
Signature:
Date:
Please
complete the form on-line then
print,
sign
and return to:
Hamlin Fistula UK
4 Parade Buildings
Nimmings Road
Halesowen
West Midlands
B62 9JJ
