Gift Aid Declaration Form

(Please tick box to confirm) 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 to charities and CASCs in that tax year, it is my responsibility to pay any difference. Please treat all donations I make or have made to Little Sisters of the Poor for the past 4 years as Gift Aid donations until further notice. I will notify Little Sisters of the Poor if my circumstances or name/address details change.

The Little Sisters Home you donated too (required)
BristolLeedsLondon St. Anne’sLondon St. Peter’sManchesterNewcastleDublin RahenyDublin Holy FamilyWaterfordGlasgowGreenock

Title (required)

Full Name (required)

Home Address (required)

Postcode (required)

Email Address (required)

Telephone (required)

Donation Amount (required)

Please note: if this donation has been collected from a third party (e.g. at a fundraising event, from a friend or family member, a sweepstake or raffle, or is being made on behalf of a company), we are unable to claim any Gift Aid on this donation.

Signed:

Date:

Little Sisters of the Poor, St Peter’s Residence, 2A Meadow Road, London SW8 1QH Registered Charity No. 234434