Gift Aid Declaration

Please complete and return this form to the following address:

The Anita Goulden Trust, 144 Bronsart Road, London, SW6 6AB, UK.

Donors Name:

Title:

Forenames:

Last Name:

Address:



Postcode:

I would like all the donations I / We make to The Anita Goulden Trust after 6th April 2000 to be treated as Gift Aid donations. Please reclaim tax on My / Our donation.

Sign:

Date: