Gift Aid Declaration

The Khoja Shia Ithna-Asheri Muslim Community of London
Registered Charity in UK No. 288356
Husaini Shia Islamic Centre, Wood Lane, Stanmore, Middlesex HA7 4LQ, United Kingdom

Telephone: +44 (0)20 8954 6247
Fax: +44 (0)20 8954 8028
Ansaphone: +44 (0)20 8954 8401
e-mail: admin@hujjat.org
Website: www.hujjat.org

Consent

Yes, I am a UK tax payer and would like KSIMC of London to claim gift aid on my donations

I am a UK taxpayer. Please treat all donations I make or have made to KSIMC of London for the past 4 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 claimed on all my donations to charities and Community amateur sports clubs (CASCs) in that tax year, it is my responsibility to pay any difference. The KSIMC of London will claim 25p on every £1 donated.

Please write clearly and with correct spellings. Please complete the form in BLOCK CAPITALS

Name

Title Forename(s) Surname

National Insurance Number*

Address*

Street Address City County Postcode Country

Your postcode is vital for our record keeping. Please ensure you enter the full postcode.

Notes

Please note you need to complete this form only once. It is valid in perpetuity. You may cancel this declaration at any time by notifying the Honorary Treasurer.
Please notify the Honorary Treasurer if you do not want the tax to be claimed on any of your donations.
Please tick the box if you pay tax at the lower rate of 20%
If you pay tax at the higher rate you can claim further tax relief in your Self Assessment tax return.
If you pay tax at the higher rate you can claim further tax relief in your Self Assessment tax return.
Please notify the Honorary Treasurer if you change your name and address.

Sadqa

General

Refurb

Donations

Notes

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