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Gift Aid Form 






25 p

By completing our Gift Aid form, your donation is worth 25% more at no extra cost to you. 

If, for example, you are a UK taxpayer and donate £1,000 in a particular tax year, PCC Burbage can claim back £250 of Gift Aid from HMRC at no extra cost to you. This increases the value of your donation to £1,250.

Upon completion and processing of your form below by the PCC Burbage Finance Team (this may take a couple of days), the team will send you a PDF copy of your declaration and a unique Gift Aid number that you can use as a refefence for donations you make by Standing Order or Bank Transfer (e.g. A.Smith/7817). 

If you change your email address, do let the team know.

Information on this form will be transmitted securely and encrypted.

In order to Gift Aid your donation you must tick the relevant box(s) and complete the form below:

I want to Gift Aid any donations I make: 

If in the past, when can we claim gift aid from (maximum 4 years ago)?

For example, if you started a new job two years ago, and you started to pay income tax, we can claim gift aid from that point.

Pentecostal Church Centre Burbage  

Registered Charity: 1051883

I am a UK taxpayer and understand that if I pay less Income Tax and/or Capital Gains Tax than the amount of Gift Aid claimed on all my donations in that tax year it is my responsibility to pay any difference.

Please also complete the following details in full, providing your home address, email, phone number, and then dating and agreeing that you shared every info truthfully.

Your Name 

Your Home Address 

Your Phone Number & Email Address 

I would like a copy of my Gift Aid Mandate to be emailed to me (this may take up to 14 days)

Date of Gift Aid Mandate 

Any other comments or Questions?

You must notify us if you:

  • Want to cancel this declaration

  • Change your name or home address

  • No longer pay sufficient tax on your income and/or capital gains.

Higher Rate Taxpayer?

If you pay Income Tax at the higher or additional rate and want to receive the additional tax relief due to you, you must include all your Gift Aid donations on your Self-Assessment tax return or ask HM Revenue and Customs to adjust your tax code.

Other taxes such as VAT and Council Tax do not qualify.

Please verify that you are human 

Thank you for submitting!

To know more about Data protection and privacy policy

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