Gift Aid Registration Form

CHARITY GIFT AID DECLARATION
Please complete the following form as accurately as possible.

Your Title:

Your First Name:

Your Surname:

Your Address

Address Line 1:

Address Line 2:

Town/City:

County/State:

Country:

Your Postcode / Zipcode:

Your Email:

Gift Aid Donation

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.

In order to Gift Aid your Donation you must indicate this and tick the box: YesNo

Information collected on this form will be held in accordance with the provisions of the General Data Protection Regulations (GDPR) for the purposes of processing your Gift Aid application.

DECLARATION
I certify that the information given in this application is complete and accurate to the best of my knowledge. Please notify the charity if you:
• want to cancel this declaration
• change your name or home address
• 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.
Please confirm you allow us to process and store the details you provide in order that we may contact in you in regards to this enquiry and you would like to be added to Epiphany Trust's mailing List.

I Agree: