Fulcrum Gift Aid Form

Fulcrum Gift Aid Declaration

Name:

....................................................................................................................

Address:

....................................................................................................................

....................................................................................................................

....................................................................................................................

Postcode:

....................................................................

Telephone:

....................................................................

Email:

....................................................................................................................

I enclose a cheque made payable to 'Fulcrum' for £ ..................

I want the charity to treat all donations I have made since 20 January 2004, and all donations I make from the date of this declaration until I notify you otherwise, as gift aid donations.

I note that I must pay an amount of UK income or capital gains tax at least equal to the tax the charity reclaims on my donations in the tax year.

Signed: ....................................................................................... Date: .............................

Please return to:
Rev James Mercer
All Saints Vicarage
175 Uxbridge Road
Harrow
HA3 6TP

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