Standing Order Form - Imperial College London Page 2

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Gift  Aid  is  a  simple  scheme  that  enables  Imperial  College  London  (SCI,  Prof  Alan  
Fenwick)  to  reclaim  the  basic  rate  of  tax  on  donations  received  from  UK  taxpayers,  
meaning  that  every  £1  you  donate  is  worth  £1.25  to  SCI.    In  addition,  donors  who  pay  a  
higher  rate  of  tax  are  able  to  reclaim  the  difference  between  the  higher  rate  and  the  
basic  rate  in  their  Self-­Assessment  Return,  bringing  the  cost  of  your  gift  down  to  75  
pence  in  the  pound,  while  still  making  the  gift  worth  £1.25  to  SCI.    If  you  are  a  UK  tax  
payer,  please  complete  the  declaration  below.    It  really  is  that  simple!  
 
Please  complete  this  section  to  make  your  gift  go  further.    
Please  treat  as  Gift  Aid  donations  all  qualifying  gifts  made  (please  tick  ALL  boxes  you  
wish  to  apply):  
 
Today    
In  the  past  4  years    
 In  the  future  
 
 
I  confirm  I  have  paid,  or  will  pay,  an  amount  of  income  tax  and/or  capital  gains  tax  for  
each  tax  year  (6  April  to  5  April)  that  is  at  least  equal  to  the  amount  of  tax  that  all  the  
charities  or  Community  Amateur  Sports  Clubs  (CASCs)  that  I  donate  to  will  reclaim  on  
my  gifts  for  that  tax  year.  I  understand  that  other  taxes  such  as  VAT  and  council  tax  do  
not  qualify.  I  understand  the  charity  will  reclaim  25p  of  tax  on  every  £1  that  I  give  on  or  
after  6  April  2011.  
 
 
Signature:  ______________________________________    Date:  _________________  
 
 
Please  notify  SCI  if  you  change  your  name  or  address.    If  in  the  future  your  circumstances  change  and  
you  no  longer  pay  tax  on  your  income  and  capital  gains  equal  to  the  tax  that  the  charity  reclaims,  you  can  
cancel  your  declaration  by  notifying  SCI  (giving@imperial.ac.uk).  
 
 
 
 
 
Please  return  your  form  to:  
SCI,  Imperial  College,  Advancement  Division,    
SALC  Mezzanine,  Level  5  Sherfield  Building,  London  SW7  2AZ  
Email:  giving@imperial.ac.uk  

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