Gift Aid Declaration Form

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Gift Aid Declaration UK FRIENDS OF YALE UNIVERSITY LTD 19 Norcott Road, London N16 7EJ, United Kingdom A Registered Charity UK Friends of Yale University, Ltd. | Registered in England | Registered Charity Number 119399 Company Registration Number 5963986 Details of donor(s) Title Forename(s) Surname Address Code Post Telephone E-mail I want UK Friends of Yale University, Ltd. to treat as Gift Aid Donations (tick as appropriate): o The enclosed donation of £ o The donation(s) of £ which I made on o All donations I make from the date of this Declaration until I notify you otherwise I am a UK taxpayer and understand that if I pay less Income Tax and/or Capital Gains Tax in the current tax year than the amount of Gift Aid claimed on all my donations it is my responsibility to pay any difference. I understand the charity will reclaim 25p of tax on every £1 that I give from today onwards. Signature Date Notes: 1. If your declaration covers donations you make in the future: > Please notify UK Friends of Yale University, Ltd. if you change your name or address while the declaration in still in force > You can cancel the declaration at any time by notifying UK Friends of Yale University, Ltd. It will not apply to donations you make on or after the date of cancellation or such later date as you specify. 2. If your circumstances change, and you no longer pay tax on your income and capital gains equal to the tax that UK Friends of Yale University, Ltd. reclaims, you can cancel your declaration (see note 1). 4. If you pay Income Tax at the higher or additional rate and want to receive the additional tax relief due to you, you must include all your Gift Aid donations on your Self-Assessment tax return or ask HM Revenue and Customs to adjust your tax code. You can mail your completed Gift Aid Declaration to UK Friends of Yale University, Ltd. at the address above or e-mail to [email protected]. Rev. 03/16.

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