Please complete and send this form to 

Eleanor Barden, 33 Booth Lane North, Northampton NN3 6JQ, UK.  

with your donation

NOTES

Gift Aid Declaration

Name of Charity         Friends House Moscow

I wish FRIENDS HOUSE MOSCOW to reclaim tax on a donation  of  £ …… …… made on (date) and any previous donations  I have made. I will pay in the current tax year an amount of income tax and/or capital gains tax at least equal to the tax that the charity reclaims on my donation (currently 28p for each £1 given)

 Full name of donor:

 Full address:  

 Signed:                                                                    Date:

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1. You can cancel this Declaration at any time by notifying the charity.

2. 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 can cancel your declaration.

3. If you pay tax at the higher rate you can claim further tax relief in your Self Assessment tax return.

4. If you are unsure whether your donations qualify for Gift Aid tax relief, ask the charity, or refer to help sheet IR65 on the Inland Revenue web site, www.hmrc.gov.uk/charities/giving-to-charities-indiv.htm

5. Please notify the charity if you change your name or address.