Hampshire and Isle of Wight Air Ambulance

HAMPSHIRE AND ISLE OF WIGHT AIR AMBULANCE

Registered Charity No: 1106234

22 Oriana Way |Nursling Industrial Estate | Southampton | SO16 0YU

Tel: 023 8033 3377 | Email: | Web:

GIFT AID DECLARATION

PLEASE COMPLETE ALLDETAILSTO ENABLE US TO BE ABLE TO CLAIM GIFT AID ON YOUR DONATIONS

Thisform must be completed by an individual – joint declarations will not be accepted by
HM Revenue & Customs, and must be completed by the tax payer.

NB: Unfortunately we can not claim Gift Aid on cheques that are from joint accounts and do not match the name of the tax payer below.

THESE FIELDS ARE MANDATORY
(Missing information will invalidate the form) / TITLE / FIRST NAME / LAST NAME
HOME ADDRESS
TOWN/CITY
COUNTY/STATE
POSTCODE
COUNTRY
(IF NOT UK)*
It would be very helpful if you could provide at least one of the following, in-case of any queries.
PLEASE NOTE, WE DO NOT SELL OR PASS ON DETAILS TO THIRD PARTIES.
EMAIL ADDRESS
CONTACT NUMBER

*If you live overseas you can complete this Gift Aid Declaration – by doing so you confirm that you are a UK Tax Payer and have paid sufficient tax in the relevant tax year(s)

By ticking the box I confirm that I am a UK tax payer and would like all my donations, past, present and future to Hampshire and Isle of Wight Air Ambulance to be treated as Gift Aid donations. I confirm that I have or will have paid sufficient tax (income or capital gains) in the current tax year to cover all the tax that will be reclaimed by all the charities or CASC to which I have made Gift Aid donations.

I understand that if I pay less income Tax and/or capital gains tax than the amount of Gift Aid claimed on my donations in that tax year it is my responsibility to pay any difference. I also understand that other taxes, such as council tax and VAT do not qualify.

I confirm that I would like to receive the Hampshire and Isle of Wight external newsletter (every 2 months) and I have provided my email address above. (Please tick this box if you agree)