NAME………………………………………………

ADDRESS……………………..…………………………………………………………………………………

………………………………….…………………………………………POST CODE………………………..

Gift Aid - I want the Church to reclaim tax on this donation.
I am a U.K. taxpayer and I note that I must have paid an amount of income tax or capital gains tax which at least equals tax deducted from my donation of £

SIGNED …………………………………………… DATE………………