JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Pothi Seva_Gift Aid Form
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Please select the option which applies to you
*
I want to Gift Aid my regular monthly donation which is sent via standing order (or Wonderful/PayPal)
I want to Gift Aid my one-off donation which is sent via standing order (or Wonderful/PayPal)
Please state the amount (in pounds) of your monthly or one-off donation
*
Your answer
Please tick any of the below, as applicable.
I want to Gift aid any donations I make in the future.
I want to Gift Aid any donations I have made in the past 4 years.
Please confirm that you qualify to make Gift Aid donations by confirming that all of the following apply:
*
I confirm that I am a UK taxpayer and pay Income Tax and/or Capital Gains Tax.
I 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.
Required
Title (e.g.: Mr, Mrs, etc)
*
Your answer
First name (include any middle name)
*
Your answer
Surname
*
Your answer
Full Home address
*
Your answer
Post code
*
Your answer
Date
*
MM
/
DD
/
YYYY
Send me a copy of my responses.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of Pothi Seva.
Does this form look suspicious?
Report
Forms