Gift Aid Declaration

If donating by cheque or by standing order, please print this form and return it by post:

The Foundation for Liver Research
The Institute of Hepatology
69 – 75 Chenies Mews,
London WC1E 6HX

Please fill in the details below:

Title:
First name:
Surname:
Address:
Postcode:
Day time telephone number:

(Please make sure we can read your full name, home address and postcode).

The Foundation for Liver Research can reclaim the tax back on every donation and get an extra 20% without it costing you a penny more.

Please tick here if you are a UK taxpayer and you would like the Foundation for Liver Research to Gift Aid your donation.

Please be aware that you must have paid an amount of income tax an/or capital gains tax at least equal to the tax that we claim from your donation in the tax year you make the donation.

Thank you for your support

The Foundation for Liver Research
c/o The Institute of Hepatology
69 – 75 Chenies Mews
London WC1E 6HX

Tel: 020 7255 9830
Fax: 020 7380 0405

Registered charity no. 268211/1134579