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					Gift Aid Declaration
Are you a UK Taxpayer? If you are a UK tax-payer, please complete this form to enable us to treat your donation as Gift Aid. This increases the value of your gift by nearly a third at no cost to yourself.
□ Yes I am a UK taxpayer and I would like Ataxia UK to treat all donations I have made since 6 April 2002, and all donations I make from the date of this declaration until I notify you otherwise as Gift Aid donations.

Or: □ Yes I am a UK taxpayer and I would like Ataxia UK to treat all donations I make from the date of this declaration until I notify you otherwise as Gift Aid donations.

You must pay an amount of income tax and/or capital gains tax at least equal to the tax that the charity reclaims on your donations in the tax year (currently 28p for each £1 you give).
Title: Forename: Surname: Telephone: Email: ___________________________ ___________________________ ___________________________ ___________________________ ___________________________ Address: ___________________________ ___________________________ ___________________________ ___________________________ Postcode: ___________________________

Signed: __________________________________________ Date: ___________________
Notes:  You can cancel this declaration at any time by notifying Ataxia UK.  If in the future your circumstances change and you no longer pay tax on your income and capital gains equal to the tax that the charity reclaims, you must cancel your declaration.  If ________________________ your donations qualify for Gift Aid tax relief ask your local tax you are unsure whether office for leaflet IR 65. ________________________  I can claim further tax relief on my tax return if I pay tax at the higher rate.  Please notify the charity if you change your name or address.
________________________

DATA PROTECTION: We would like to contact you occasionally with information about Ataxia UK and ________________________ other ways you might be able to support our work. If you would rather we didn’t contact you in this way just tick the boxes below: ________________________ □ Please do not send me by post occasional updates on Ataxia UK and other ways I can support its work. □ Please do not send me by email occasional updates on Ataxia UK and other ways I can support its work.

ATAXIA UK FREEPOST RLXR-BKKK-EXZU, ATAXIA UK, LONDON, SW9 6EJ
Or

Winchester House, Kennington Park, Cranmer Road, London SW9 6EJ Tel: 020 7582 1444 E-mail: office@ataxia.org.uk Fax: 020 7582 4999 Registered Charity No:1102391 Registered Company No: 4974832


				
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