When donating to the Prince of Wales Hospice help us claim back Tax from the government by declaring your donation with Gift Aid.

1. Using Gift Aid means that for every £1 you give we can claim an extra 25p from Her Majesty's Revenue and Customs,
helping your donation go further, at NO EXTRA COST to you.
DECLARATION:
That you agree to The Prince of Wales Hospice to act as a selling agent for the goods
you have donated, an agencey fee will be deducted from the sale of your goods
for this service - which will be donated directly to The Prince of Wales Hospice.
(Please note we reserve the right to terminate the agency agreement at any time; without notice)
You want The Prince of Wales Hospice to treat all donations you make from the date of this declaration , until you notify us
otherwise, as Gift Aid donations. You confirm that you will pay an amount of UK Income and/or capital gains tax, at least
equal to the amount of tax we (and any other Charity or Community Amateur Sports Club (CASC`s) to whom you also
donate) reclaim on your donations, in the appropriate tax year. Please note that other taxes such as VAT and Council Tax do
not qualify.
TO CONFIRM BOTH OF THE ABOVE STATEMENTS PLEASE TICK HERE
The data you provide will be used for Gift Aid administrative purposes, and from time to time with details of our products or
services that may be of interest to you. If you prefer not to receive these messages please tick the relevant box.
By post By telephone By email
GIFT AID DECLARATION FORM
FOR COMPLETION BY/ON THE BEHALF OF THE DONOR:
* Denotes required field
TELEPHONE NUMBER:
* POSTCODE:* TOWN:
* FULL ADDRESS:
* SURNAME:* FORENAME:* TITLE:
EMAIL ADDRESS:
DATE:SIGNATURE:
SIGNED BY THE DONOR:
FOR ORIGINATOR USE:
This agreement can be cancelled at any time by the donor by contacting the Gift Aid Team on 01977 781464
SHOP NUMBER:
SHOP NAME:
DATE:
FORM CHECKED: FORM ENTERED:
DATE:
FOR GIFT AID OFFICE USE:
ONCE COMPLETED THIS FORM SHOULD BE SENT TO THE GIFT AID OFFICE
The Five Towns Plus Hospice Fund Limited
The Prince of Wales Hospice, Halfpenny Lane, Pontefract, West Yorkshire, WF8 4BG
Telephone 01977 708868 Fax 01977 790444 Web www.pwh.org.uk
Charity Registration No: 514999