Gift Aid Single Donation Form

Please print out the form below and return completed and signed to;                  

EKPCA, Maidstone Masonic Centre, Tovil, Maidstone, Kent. ME15 6QS

Telephone: 01622 766212.    Email:

Beneficiary Charity:              EAST KENT PROVINCIAL CHARITIES ASSOCIATION

Registered Charity Number: 1023859

Donor: (Full names) …………………………………………………………………………………………………

Donor Address………………………………………………………………………………………………………

                         ………………………………………………………………………………………………………

Post Code: ……………………  Tel. No. ………………........... Email ..............................................................................................................

Declaration:  Please treat all donations I have made since 6 April 2000 and all donations I make thereafter as Gift Aid donations and reclaim the tax thereon.

Tax Requirement:  I, as donor, acknowledge that I will notify you in writing if I no longer pay an amount of Income Tax or Capital Gains Tax equal to the tax that EAST KENT PROVINCIAL CHARITIES ASSOCIATION reclaims on my donations.

Signed:………………………………………………………..                                  Date:………………………………..

Credit to Lodge Name & No. ……………………………………………………………………………………………...

Please apply my donation of £..............................................................  to:

2014 Festival	Freemasons' Grand Charity	MSF	RMBI
RMTGB	PGM’s Charity	To Be Advised	Other (Supply details below):

(Please tick your choice. If more than one is indicated donations will be divided equally)

Charity  ……………………………………………………………………………………………………………………………

Address............................................………………………………………………………………………………………………

Data Protection Act: If you do not agree to the details of your account with the Association being made available to your Lodge Charity Steward, please tick :