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, London               
111 Coldharbour Lane                                  
London, SE5 9NT                                       

                                                                                            

Please fill in the details below.                           

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

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

 

Please tell us if your donation is made in memory of a friend or loved one.

This donation is made in memory of:

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

The Foundation for Liver Research can reclaim the tax back on every donation and get an extra 25% 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. Your donation can help save people's lives.

                                                           

The Foundation for Liver Research                
c/o The Institute of Hepatology, London       
111 Coldharbour Lane                                  
London, SE5 9NT                                        

Tel: 020 7255 9830                               

Fax: 020 7380 0405                              

Registered charity no. 268211/1134579

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