Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Gift Aid Declaration *

Please claim Gift Aid on my donations to Holy Trinity Brompton (Charity Number 1133793). This includes all donations for this year and the previous four years, plus any future donations, unless I notify you otherwise. I confirm that I am a UK taxpayer and have paid or will pay sufficient Income or Capital Gains tax in each tax year to cover all the tax that will be reclaimed by all the charities or Community Amateur Sports Clubs to which I have made Gift Aid donations in any tax year covered by this declaration. I understand that I am responsible for paying any tax shortfall. Please let us know if any of your personal details change, or if you no longer pay sufficient tax on your income and/or capital gains.