| MAKING A DONATION TO QUIT ® (close this window to return to the QUIT site) To make a donation, however small, please print this page and return the completed form, with payment where applicable, to: QUIT, FREEPOST 20 (LON 214 28), London EC1B 1QA Please find enclosed my cheque/postal order/CAF voucher ( delete as applicable ) made payable to QUIT for: £100 £50 £25 £10 £5 Other
amount _____________ or debit my: Expiry date:_________________Switch Issue No.________/____________ Card no. I__I__I__I__I__I__I__I__I__I__I__I__I__I__I__I__I Please charge £_________ to my card. Name: Mr/Mrs/Ms/Miss/Dr ______________________ Address:_________________________________________________________________________
Postcode:________________________________ I want QUIT to treat**
Signature of donor: _____________________ Date: _____________ NOTES. 1. If your declaration covers donations you make in the future, a) please notify QUIT if you change your name and address while the declaration is still in force, or b) you can cancel the declaration at any time by notifying QUIT - it will then not apply to donations you make on or after the date of cancellation or such later date as you specify. 2. You must pay an amount of income tax and/or capital gains tax at least equal to the tax that the charity reclaims on your donations in the tax year ( currently 28p for each £1 you give ). 3. If in the future your circumstances change and you no longer pay tax on your income and capital gains equal to the tax that the charity reclaims, you can cancel your declaration ( see note 1 ). 4. If you pay tax at the higher rate you can claim further tax relief in your Self Assessment tax return. 5. If you are unsure whether your donations qualify for Gift Aid tax relief, ask the charity. Or you can ask your local tax office for leaflet IR113 Gift Aid. Thank
you for your support |