Charity Name:

                          SUSILA DHARMA (BRITAIN)

                         Gift Aid Declaration

In order for Susila Dharma (Britain) to reclaim tax on your donations you must pay an amount of income tax and/or capital gains tax at least equal to the tax that we reclaim on your donation in the tax-year of the donation. Higher rate taxpayers can claim further tax relief in their self-assessment tax returns.
No signature is necessary on this form
Please complete in Block Capitals using only the names known to your tax office.

Details of donor  (please - no joint donations)

Title…………  Forenames(s)………………………………………………….    Surname……………………………………………………………………..…
Address …………………………………………………………………..……
 …………………………………………………………………………………

                                                         Post Code……………………………….

I am a taxpayer and I want Susila Dharma (Britain) to treat all donations I have made since 6 April 2000, and all donations I make from the date of this declaration until I notify them otherwise, as Gift Aid donations.

 Date: ……./……/…..…. SD(B)donor reference number (For Office use only)  

SD(B) encourages donations to the General fund, as this gives flexibility to apply money where the needs are greatest. We request that tax relief from earmarked donations should go into the General  fund – please tick the box below if you do not want this to happen.  

  I wish tax relief on my earmarked donation(s) to be added to the earmarked fund(s)                                                            

Since your declaration covers donations you may make in the future, please notify Susila Dharma (Britain) if: 
              ·        You change your name and address while the declaration is still in force.
             ·        Your circumstances change i.e. you no longer pay tax on your income or capital gains tax equal  to the tax that Susila Dharma (Britain) reclaims

You can cancel the declaration at any time by notifying the treasurer of Susila Dharma (Britain).The declaration will then not apply to donations you make on or after the date of the cancellation or such later date as you specify.

 It  is recommended that you make a copy of the completed declaration.

The Treasurer of Susila Dharma(Britain) is Stephen Weil, 126 Doversgreen Road
Reigate, Surrey, RH2 8DW

treasurer@susiladharma.org.uk        Tel:    01737 249637