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Please read and confirm the following statements I am donating my own money and the funds have not come from anyone else including family members or from an office or bucket collections The money I am donating is not the proceeds from sales of goods or services or the sales of tickets I have not received something in return for this donation such as an entry ticket to an event or a raffle ticket

*This includes any donations you have made in the past four years and all future donations. To qualify for Gift Aid, you must be a UK taxpayer and understand that if you pay less Income Tax and/or Capital Gains Tax than the amount of Gift Aid claimed on all your donations in that tax year it is your responsibility to pay any difference. Please notify InMem if you want to cancel this declaration, change your name or home address, or no longer pay sufficient tax on your income and/or capital gains.

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