Charity claim form


If you want the charity to reclaim tax on a donation. You will need to fill in a simple form, below. This will enable the charity to claim 28p for every £1 back from the government.

Charity  ……………………………………………………….....

In memory of  …………………………………..……………….

Full Name  ……………………………………..………………..

Address  …………………………………………..……………..

……………………………………………………….…………..

……………………………………………………….…………..

  • I want the above charity to reclaim tax on the enclosed
donation.
  • I note that I must have paid an amount of tax that at least equals the tax deducted from this donation. (28p for every £1)

Amount  ………… Chq/Cash   Date  ……………………….
M Coghlan Ltd, Westbury Road, Fareham, PO16 7XU.