Gift aid declaration

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Title*

Your Name*

First Last

Your Address*

Address Line 1 Address Line 2 City Postcode

Email address*

Phone number*

Gift Aid*

I am happy for all gifts of money I have made to Birmingham Hospice in the past four years and all future gifts of money that I make to be Gift Aid donations. 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.

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I have read and agree to the website terms and conditions