Donate in memory of
Please complete this form, attach your donation and post to:
Operations Manager, Age Concern Sutton, 1 / 2 Lower Square, Civic Centre,
Sutton. SM1 1EA.
Title (Mr/Mrs/Ms/Miss)_________ Initial(s)_________ Surname______________
Address__________________________________________________________
___________________________________________ Postcode_____________
Tel No_____________________________________ Date of Birth___________
Email ___________________________________________________________
 Please tick this box if you agree to receive information from Age Concern Sutton.
I enclose a Cheque/ Postal Order payable to Age Concern Sutton
I wish to make a gift of (please circle)
£6
£10
£15
£25
£50 or my preferred amount of £
Signed
Date
Gift Aid it
Your donation can be worth more at no extra cost to you, e.g. you can turn your
donation of £15 into £19.23.
In order for us to claim tax, you must have paid an amount of income tax and/or
capital gains tax at least equal to the tax that the charity reclaims on your
donation in the tax year. If you are a higher rate taxpayer you can claim further
tax relief on your self-assessment tax return.
Please check you have paid sufficient income or capital gains tax otherwise the
donor may be liable to pay the additional amount to the Revenue.
I wish the charity to treat all donations I have made since 6 April 2009 and all
donations I make from the date of this declaration until notify you otherwise as
GIFT AID DONATIONS.
Signature……………………….…..
Date…………………………