Ambulance Services Benevolent Fund
Registered Charity No: 800434
Gift Aid Form

Thank you for agreeing to allow the Ambulance Services Benevolent Fund to claim tax on your gifts
under the Gift Aid scheme. It will help your donation go even further by allowing us to claim an extra
28p for every £1 you donate to us.

In order for the Ambulance Services Benevolent Fund to reclaim the tax you have paid on your
donation(s) you must have paid UK Income or Capital Gains tax equal to the tax that will be
reclaimed. Please remember to notify us if in the future you stop paying UK tax or no longer pay
sufficient Income or Capital Gains tax to cover the amount we will claim back.

Your commitment is very important to us, so please accept our thanks for this valuable contribution
to our work. As a direct result of your Gift Aid declaration, we will be able to offer even more help
to ambulance personnel who need it most, thank you.

The ASBF Trustees

__________________________________________________________________

Ambulance Services Benevolent Fund
Registered Charity No: 800434

I authorise the Ambulance Services Benevolent Fund to reclaim tax on any donation I make from
the 6th April 2000 onwards under the Chancellor’s Millennium Gift Aid Scheme. I confirm that I
pay sufficient tax (Income or Capital Gains tax) to equal the amount the Ambulance Services
Benevolent Fund will reclaim (currently 28p for every £1 donated).

Title:                             Surname:                                              First Name:

Full Address:

(with Post Code)

 

 

Signature:…………………………………...  Date:……………………………………

(you are not committing yourself to make future donations) 


Please confirm (tick appropriate boxes and insert frequency if making regular donations) 

One-off Donation
Regular Donation
Frequency

Amount:
£1
£5
£10
£20
Other

Please Return to:
ASBF Secretary, Cherith 150 Willingdon Road, Eastbourne, East Sussex, BN21 1TS