Gift Aid Form

With a Gift Aid declaration, for every £1 you donate, Haematology Cancer Care can claim an extra 25p from HMRC. You can change this declaration at any time by contacting us.

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Title *

Name *

First

Last

Address 1 *

Address 2 *

City *

Country *— Select Choice —United Kingdom

Postcode *

Date *

Gift Aid Declaration *

• By ticking this box, I confirm that I want to Gift Aid my donation and any donations I make in the future or have made in the past 4 years to Haematology Cancer Care / UCLH Charity. I am a UK taxpayer and understand that if I pay less Income Tax and/or Capital Gains Tax than the amount of Gift Aid claimed on all my donations in that tax year it is my responsibility to pay any difference.

Declaration 2 Policy

Privacy Policy *

• I agree to the privacy policy.

Submit

Privacy Policy

Please let us know if you:

• Want to cancel this declaration 
• Change your name or home address
• Your tax status changes and you no longer pay sufficient tax on your income and/or capital gains to cover Gift Aid claims

If you have any questions or need help completing this form, please email uclh.hcc@nhs.net