Ucl Hospitals Charitable Foundation Donation Form - Brighter Futures Page 2

Donation Form

Gift Aid Declaration

I am a UK tax payer and I would like Brighter Futures to treat all donations I have made for the

four years prior to this year and all donations I make in the future as Gift Aid donations until I

notify you otherwise. I understand that if I pay less income tax and/or Capital Gains tax in a tax

year than the amount of Gift Aid claimed on all of my donations in that tax year it is my

responsibility to pay any difference.

Please sign: _______________________________ Date: _____________________________

□ We would like to keep you updated on the work of Brighter Futures Charity. Please tick this

box if you would prefer not to be added to our mailing list.

Please return this completed form to:

Brighter Futures

Brunel Treatment Centre

Great Western Hospital

Marlborough Road

Swindon

SN3 6BB

Thank you for your support

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