Name *

First Name

Last Name

I want to Gift-aid all my donations to Chabad of Bristol from the above date and the past 4 years. I am a UK taxpayer and 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. *

Please notify us if any of the above information changes.

YES!

Date

MM

DD

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