Donation Information
Amount:
£
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Designation:
Funeral Collection
In Memoriam personal donation
Other
Other
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Comments:
Gift Aid:
Gift aid can only be claimed on personal donations and not collections. By ticking this box I agree that this is a personal donation and would like to treat all donations I have made to Alzheimer Scotland for the past four years and any I make in the future as Gift Aid donations until further notice. 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. We will reclaim 25p of tax on every £1 that you have given.
What is Gift Aid?
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Title:
<Please select>
.
Dame
Dr
Her Honour
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Sir
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First name:
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County:
Edinburgh, City of
Isle of Canna
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Phone:
Email:
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Payment Information
Cardholder's Name:
*
Credit Card Number:
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Card Type:
Visa
American Express
Discover
Maestro
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Valid From:
01
02
03
04
05
06
07
08
09
10
11
12
/
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
(Maestro/Switch/Solo only)
Card Expiry:
01
02
03
04
05
06
07
08
09
10
11
12
/
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
*
Issue Number:
(Maestro/Switch/Solo only)
Card Security Code:
*
Note: The Card Security Code is not required for Maestro, Switch and Solo cards.
Tribute Information
This donation is in memory of
Type:
In Memory
Forget Me Not Fund
*
Name:
*
First name:
Surname:
*
Would you like us to inform the next-of-kin about your gift?
*