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Gift Aid Form

FMA UK
P O Box 206
Stourbridge
DY9 8YL

If you pay UK Income Tax - like tax on your pension if you are retired, or Capital Gains Tax, or tax on the interest from your savings - then every donation you make, or have made since 6th April 2000, could be worth almost a third more to FMA UK, without any cost to you.

If you want to help FMA UK to maximise the impact you make through your donations, all you have to do is complete this form and return it to us.

* *Please note there is no extra cost to you for completing this form * *

I wish Fibromyalgia Association UK (Registered Charity No.1042582) to treat all donations I have made since June 2004 and all donations I make from the date of this Declaration until I notify you otherwise, as a Gift Aid donation.

I pay Income and/or Capital Gains Tax at least equal to the tax Fibromyalgia Association UK reclaims on my donations in the tax year.

Title:	Mr. Mrs. Miss Ms. Dr. Prof. Other
Name:	*
Email Address:	*
Address :	*
Postcode :	*
I confirm I am a UK taxpayer?	Yes No *

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