Gift Aid declaration form

Gift Aid declaration form
Thank you so much for supporting families
Using Gift Aid means that for every pound you give, Dementia UK gets an extra
25 pence from HM Revenue & Customs, ensuring your donation will help more
families receive the specialist dementia support they need.
First name:
House No/Name:
Home address:
Your Gift can be worth 25% more to Dementia UK at no extra cost to you.
Simply read the statement below and tick if you would like us to claim Gift Aid on your donation.
I am a UK Tax Payer. Please treat all donations I make or have made to Dementia UK for the past four
years as Gift Aid donations until further notice.
I understand that if I pay less Income Tax and/or Capital Gains Tax than the amount of Gift Aid
reclaimed on all my donations in that tax year it is my responsibility to pay any difference.
Gift Aid is reclaimed by the charity from the tax you pay for the current tax year.
Stay in touch:
We’d like to keep you updated about how your support is making a difference, fundraising activities and other
ways you can get involved.
Yes, I would like to be updated by post.
Yes, I would like to be updated by email.
My email address is:
You can view our full privacy policy and how we use your information at
If you ever want to change how we communicate with you, contact our Supporter Care team on
0300 365 6600 or by email at [email protected]
Please return this form to:
Dementia UK, Freepost RTSS-HAEL-SCXB, Second Floor,
356 Holloway Road, London, N7 6PA
Dementia UK registered charity 1039404