Name *

First Name

Last Name

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Please treat the following donations as Gift-Aided. I confirm that I am a UK taxpayer and that I have paid at least as much UK Income Tax and/or Capital Gains Tax for the year of donation as Chabad Lubavitch of Nottingham, and any other Charities I have Gift-aided donations to will claim on my donation *

FUTURE DONATIONS FROM DATE ABOVE

AND FROM LAST 4 FINANCIAL YEARS

BEGINNING FROM DATE BELOW

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