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* 1. I want to Gift Aid any donations I make in the future or have made in the past 4 years to The Camberwell Society

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* 2. 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.

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* 3. Name

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* 4. Address (as used by HMRC)

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