To Gift Aid your donation please fill in below:

I want to Gift Aid any donations I make in the future or have made in the past 4 years to:

The Friends of Holland Park. Registered as a Charity No 281348

I am a UK taxpayer and understand that if I pay less Income Tax and/or Capital Gains Tax than the amount of Gift Aid claimed on all my donations in that tax year it is my responsibility to pay any difference.

Donor/First Member

Title *

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First name or initial(s) *

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Surname *

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Address line 2

Postcode *

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Joint Member (only applicable when donor is a joint member and both reside at the same address)

I am a UK taxpayer and understand that if I pay less Income Tax and/or Capital Gains Tax than the amount of Gift Aid claimed on all my donations in that tax year it is my responsibility to pay any difference.

Please notify The Friends of Holland Park if you:

• Want to cancel this declaration.
• Change your name or home address.
• No longer pay sufficient tax on your income and/or capital gains.
• 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.