Residential Address

Correspondence Address (if different to that of the above)

Bank Details

Please note that your account registered with Achisomoch may only be credited with funds from a bank account registered in your name.

Gift Aid Declaration – for past, present and future donations
(individuals only)

If you wish that we claim gift aid, please answer the following 2 questions:

This field must be ticked if you want us to claim Gift aid on your behalf

I am a UK taxpayer and understand that if I pay less Income Tax and/or Capital Gains Tax than the amount of Gift Aid claimed on all my donations in that tax year it is my responsibility to pay any difference.

I understand the charity will reclaim 25p of tax on every £1.

Please notify Achisomoch 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

If you pay Income Tax at the higher or additional rate and want to receive the additional tax relief due to you, you must include all your Gift Aid donations on your Self Assessment tax return or ask HM Revenue and Customs to adjust your tax code.

Please review the confirmations below and tick the relevant boxes to confirm acceptance.

I hereby confirm that I have read and understood the Terms and Conditions (T&Cs) of AAC. I will ensure that the operation of this account complies at all times to these T&Cs

T&Cs can be found here: Terms & Conditions

We may occasionally send you marketing e.g. information, newsletters and other non-service related communications. Please tick this box to confirm you are happy to receive these communications

How did you hear about us?