Sponsorship and Gift Aid declaration form

Name of charity (ies)*…………………………………………..
*Donations will be split between charities in the following proportions……………………….

We, who have given our names and addresses below, and who have ticked the box headed ‘Gift Aid? (?)', want the charity (ies) named above to reclaim tax on the donation detailed below, given on the date shown. We understand that each of us must pay an amount of income tax or capital gains tax equal to the tax reclaimed by the charity (ies) on the donation.

Sponsor’s full name	Home address	Post code	£	Date paid	Gift Aid?
Total donations received			£

To be completed by the charity:

Date money received
Total Gift Aid donations	£	x22/78 =	£	tax reclaimable £