I am a UK taxpayer and I confirm the donation I make today is my own money and not part of a collection or a business donation, and I understand that if I pay less Income and/or Capital Gains Tax in the current tax year than the amount of Gift Aid claimed on all my donations it is my responsibility to pay any difference.

Please notify Eden Valley Hospice & Jigsaw if you:

• Want to cancel this declaration
• Change your name or home address
• No longer pay sufficient tax on your income and/or capital gains