GiftAidDecInfoWEB2011

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					                                                                  SURVIVE-MIVA
                                   5 Park Vale Road, Aintree, Liverpool L9 2DG
    Tel: 0151 523 3878 Fax: 0151 523 3841 E-mail: info@survive-miva.org Website: www.survive-miva.org
                                               Registered Charity No. 268745
                                                ________________________________________________________________________________________________




                                                        GIFT AID DECLARATION
        I am a UK tax-payer                             I do not pay tax, or I pay insufficient tax to be able to Gift Aid my donation(s)*
    SURNAME: ...…..………………………………………………………………... INITIALS: ……………… TITLE: ………
     (BLOCK CAPITALS PLEASE)                                                                                                                                         (Mr/ Mrs/ Miss/ Ms etc.)

    ADDRESS: …………………………………………………………………………………………………………………………..
      ...……………………………………………………………………………………………….. POSTCODE: …………………..


         Please treat all donations to SURVIVE-MIVA for the 4 years prior to this year and all donations I make on and
                       from the date of this declaration until I notify you otherwise, as Gift Aid donations.*
                                               If I cease to pay tax I will notify you.
    SIGNED: …………………………………………………………………………………… DATE: ……………………………….
                   *To qualify for Gift Aid the donor must pay an amount of UK income tax or capital gains tax at least equal to the
                     amount of tax the charity will claim in the tax year (currently (from 6 April 2008) 25p for every £1 donated).

                       SURVIVE-MIVA is obliged to store data from Gift Aid declarations in case of audit by the Inland Revenue.
      We also retain contact details on our database so that we can send out, twice-yearly, our free magazine, Awareness - if you do not wish to
                                                  receive this publication then please tick this box
               N.B. If you receive Awareness already we will know this: only tick the box if you no longer wish to be on our mailing list.

    …………………………………………………………………………………………………………………….

                                                                   What is GIFT AID?
The UK Gift Aid scheme came into effect on 6/4/2000: it means that all donations to charities are eligible for refunds from the
Inland Revenue if the donor pays tax. NO details of your tax affairs are required, but the donor must pay an amount of UK
income tax and/or capital gains tax at least equal to the amount of tax all the charities the donor has donated to will reclaim in
the tax year (currently (from 6 April 2008) 25p for every £1.00 donated).
So that SURVIVE-MIVA can recover refunds on your donations we need to have a signed and dated declaration from you
which shows that you agree to us claiming the tax refund on your gift. You need sign a Gift Aid Declaration only once, this will
then count for all/any future donations where we can clearly identify that you are the donor (that is why we need your name
and address each time you make a donation and you want us to claim the tax refund). SURVIVE-MIVA must make any claim
to the Inland Revenue within four years of the end of the accounting period to which the claim relates e.g. SURVIVE-MIVA’s
claim for Gift Aid donations made during our financial year ending on 31/12/2006 had to be made by 31/12/2010.
 Please note that:-
•     You can cancel your Gift Aid declaration at any time by notifying SURVIVE-MIVA.
•     If your circumstances change and you no longer pay enough income tax or capital gains tax to cover the amount claimed
      by SURVIVE-MIVA, you should cancel your declaration.
•     If you pay tax at the higher rate you can claim a further tax relief via your Self Assessment tax return.
•     You should notify SURVIVE-MIVA if you change your name and/or your address.
                          ————–—————————————————————————————————————————————————-
                          Please send the completed Gift Aid declaration (above) to the following address:-
                                                                     SURVIVE-MIVA
                                                                  5 PARK VALE ROAD
                                                                  LIVERPOOL L9 2DG
                                 —————–————————————————————————————————————————————————————————————————————

             Tel: 0151 523 3878       Fax: 0151 523 3841                     E-mail: info@survive-miva.org                                         Website: www.survive-miva.org
                                                                      Registered Charity No. 268745

				
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