COTSWOLD CANALS TRUST

Pike Bridge Appeal

To: The Cotswold Canals Trust, 44 Black Jack Street, Cirencester, Glos GL7 2AA.

I would like to make a donation to the Pike Bridge Appeal .

I have enclosed my cheque for the donation.

I have completed the Gift Aid Declaration (below).

(* Please delete as applicable)

Name: ..........................................................

Donation: £ .........................

Gift Aid: I wish / do not wish* this contribution to be treated as a Gift Aid donation.

(* Please delete as applicable)

If you do not have a standing arrangement with the Trust to claim Gift Aid on all your donations, please also fill in the form below.

If your donation is more than £5000 and you wish your name to appear on the commemorative plaque to be mounted on or near the bridge, please write below how you would like it shown and provide a telephone number or email address in case we need to discuss the format with you.

........................................................................................................................................

Contact details: ............................................................................

Gift Aid

Gift Aid legislation means that your contributions to the Trust can now be worth MORE - at no cost to you

The new law means that the Trust can reclaim the tax that you have paid on all contributions you make after 6^th April 2000.

This adds 28p to every £1.00 you give to the Trust

It is very easy to arrange - all you need to do is give us permission to reclaim the tax that you have already paid on the amount of your contributions.

Please help us to increase our income to bring forward the day when our canals are fully restored

There is no commitment to make further contributions and no minimum amount.

If you are a taxpayer, please fill in the details on the form below.

Most people pay enough tax to qualify whether it is by way of salary, pension or income from investments

Gift Aid Declaration

To the Cotswold Canals Trust - Charity No: 269721

Title .......... Forenames ........................................................... Surname: .................................

Address: ...................................................................................................................................

.................................................................................................................................................

Postcode: ...................................

I wish the charity to treat my contribution as a Gift Aid Donation.

Signature: ............................ Date: ............../.................../....................

Notes:

1. To make a Gift Aid Declaration, you must pay Income Tax at least equal to the amount we will reclaim on your payment (currently 28p for each £1 you give)

2. Please notify us if your name/address changes or you cease to be a taxpayer or if you wish to cancel the Declaration for whatever reason

3. For joint Accounts please ensure that the partner paying the tax we will reclaim is the one signing the declaration