Charity Gift Aid Form

    Donor Details

    Title

    First name or initial(s)

    Surname

    Home Address

    Donation Amount

    Post Code

    Home phone

    Mobile phone

    Email address

    Donor Declaration

    I want to Gift Aid my current donation and any donations I may make in the future or have made in the past 4 years to Manuptocancer.

    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 will notify Manuptocancer of any change in my personal circumstances, such as name and address, or that I no longer pay UK Income or Capital Gains tax or I wish to cancel the declaration.

    Signature

    Date

    X
    X