Surname:..................................................................................................................
Forename(s):............................................................................................................
Address:...................................................................................................................
Postcode:..................................... Telephone number:............................................
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I want the Lions part to reclaim tax on this donation of £.......... and any I make hereafter, all of which are to be treated as GIFT AID DONATIONS until I notify the charity otherwise.
Signed: ..............................................
Date: ..............................................
Please return the completed form to:
The Treasurer,
the Lions part,
44 Holmewood Road,
London,
SW2 3RR
For completion by the Lions Part:
Donation record number:
Information checked:
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