GIFT AID DECLARATION


Name of Charity:               BLEAKHOLT ANIMAL SANCTUARY

Registered Charity No:      1110503

Details of Donor:

Title........Forename(s).............................................................Surname................................................

Address..................................................................................................................................................

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

.......................................................................................................................Postcode.........................

I want the Charity to treat the following as Gift Aid donations:

          * The enclosed donation of £.............................

          *  The donation(s) of £........................ I made on ........................................

          * All donations I make from the date of this declaration until I notify you otherwise.

          * All donations I have made since 6 April 2000, and all donations I make from the date of this declaration
             until I notify you otherwise.

     * Delete as appropriate


Signature: ............................................................................................. Dated: ....................................

Notes:

     1.  If your declaration covers donations you may make in the future:

          > Please notify the charity if you change your name or address while the declaration is still in force.

          > Cancel the declaration at any time by notifying the charity - it will then not apply to donations you
              make on or after the date of cancellation or such later date as you specify.

     2.  You must pay an amount of income tax and/or capital gains tax at least equal to the tax that the
           charity reclaims on your donations in the tax year (currently 28p for each £1 you give).

     3.  If in the future your circumstances change and you no longer pay tax on your income and capital
          gains equal to the tax that the charity reclaims you can cancel your declaration (see note 1).

     4.  If you pay tax at the higher rate you can claim further tax relief in your Self Assessment tax return.

     5.  If you are unsure whether your donations qualify for Gift Aid tax relief, ask the charity.  Or you can
          ask your local tax office for leaflet IR113 Gift Aid.