Gift Aid - Chelmsford Srinivasa Perumal Temple

Charity Gift Aid Declaration

1. Donor Details

First Name

Last Name

Full Home Address

Postcode

Date

2. Donation Details

Donation Amount (£)

Bank Transfer Reference

3. Declaration

Signature Postcode Full

Declaration

I want to Gift Aid my donation

I confirm that the details I have provided are correct and I want to Gift Aid this donation, and any donations I make in the future or have made in the past four years, to Chelmsford Srinivasa Perumal Temple, registered charity number 1212128. 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

4. Signature Section

Print Name

Signature

Clear Signature

Please sign above using your finger or mouse to confirm your declaration

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Who should complete this form?

Charity Gift Aid Declaration