Donor's Full Name *

First Name

Last Name

Donor's Home Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Declaration *

By completing this form, you confirm that you are a UK taxpayer and would like Nafsiyat Intercultural Therapy Centre to reclaim Gift Aid on your donation and any future donations. You understand that you must pay Income Tax and/or Capital Gains Tax at least equal to the amount Nafsiyat reclaims and that it is your responsibility to pay any difference. Please notify us if you want to cancel this declaration, change your name or home address, or if you no longer pay sufficient tax. If you are a higher or additional rate taxpayer, you can claim further tax relief via your Self-Assessment tax return or by asking HMRC to adjust your tax code.

I confirm I am a UK taxpayer and would like Nafsiyat to claim Gift Aid on my donation. I understand it is my responsibility to pay any difference if I pay less Income Tax and/or Capital Gains Tax than the amount claimed.