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Gift Aid Declaration Form


  • 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
  • Please write clearly and with correct spellings. (Documents with wrong spellings will create problems for you at later dates).
    I am a UK tax payer. Please treat all donations I make or have made to KSIMC of London for the past 2 years as Gift Aid donation 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 complete in BLOCK CAPITALS
  • Your post code is vital for our record keeping. Please ensure you enter the full post code.
  • Notes:
    • Please note you need to complete this form only once. It is valid in perpetuity. You may however cancel this declaration at any time by notifying the Honorary Treasurer.
    • Please notify the Honorary Treasurer if you do not want 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.