Gift Aid Written Record N.B. To enable the charity to claim tax 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 donation in the tax year. Higher rate tax payers can claim further tax relief in their self assessment tax returns. Please complete in BLOCK CAPITALS Charity Name:          Friends of the National Museum of Women in the Arts, UK Registered Charity No. [1118170] Details of donor Title ……..     Forename(s) …………………………..      Surname ……………………… Address ……………………………………………………………………………………….                ……………………………………………………………………………………….               …………………………………………………     Postcode ………………………   On ……../…….../…….. you declared that you wanted the charity to treat The donation of £……………… which you made on ……../…….../……..* All donations you make from the date of this declaration until you notify the charity otherwise* all donations you have made for the six years prior to this date (but no earlier than 6 April 2000) and all donations you make from the date of this declaration until you notify the charity otherwise*   as Gift Aid donations                                                                       *delete as appropriate   Date ……../…….../…….. You have the right to cancel your declaration within 30 days of the date of this written record.  The cancellation will take effect from the date of your declaration.  Any cancellation after this time will only take effect from the date you notify the charity. Please notify Friends of the National Museum of Women in the Arts, UK. C/o Fir Tree House, 4 The Brow, Chalfont-St-Giles. Bucks HP8 4JD if:- You change your name or address while the declaration is still in force. Your circumstances change in such a way that you no longer pay income tax or capital gains tax equal to the tax that the charity reclaims on your donation. You wish to cancel your declaration. You may find it useful to keep a copy of this form among your records to help keep account of your charitable giving.