To:- 	

River Church
Bank House
81 St Jude’s Road
Englefield Green
Surrey TW20 0DF

If you are a UK tax payer and sign the declaration below, your donations will be increased by 25% where applicable.

Declaration
I would like to Gift Aid my donations (please tick all that apply):

Made today           	and in the past 4 years	 		and in the future

I am a UK tax payer and understand that, if in any tax year my income tax and / or capital gains tax is less than the amount of Gift Aid claimed on all my donations, it is my responsibility to pay any difference.

Donor’s details

Title	First name or initial(s)    	

Surname    	

Full home address    	

Post code	 	    Date ____________________________

Signed	 	

Please return to the address at the top of this form

Please notify us 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. You can request an annual statement of your giving by emailing finance@riverchurch.org.uk

River Church   finance@riverchurch.org.uk
Registered Charity No 1146525 
A Company Limited by Guarantee Registered in England No. 7926500