Gift Aid Declaration Form
Lostwithiel U3A is a Registered Charity (No 1179338) and can reclaim gift aid from the tax you pay for the current tax year. We need the following details in order to claim gift aid. Your address is needed to identify you as a current UK taxpayer.

1. Please notify the Membership Secretary if you a) wish to cancel this Declaration; b) change your name or home address; c) no longer pay sufficient tax on your income and/or capital gains. Gift Aid is linked to basic rate tax, currently 20%, which allows charities to reclaim 25p for every £1 donated.

2. 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 HMRC to adjust your tax code.

Email address *
Please treat as Gift Aid donations all qualifying gifts of money made from the date of this Declaration and in future years. 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 tick the box below. *
Your Name *
Your answer
Full Home Address *
Your answer
Today's Date - Please enter in format dd / mm / yyyy *
Your answer
Storing your response
The information you provide on this form will be held on a secure database operated by Google. Google's privacy policy may be read at The information will be used solely for the purposes of claiming Gift Aid from HMRC. Your information will not be shared with any third parties other than HMRC in order to claim gift aid.
I consent to my data being used for the purposes detailed above. *
Your Membership Number (if known)
Your answer
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