Donation amount:  £ Name of deceased:

Donor Details Name: Email: Address: Postcode: Telephone: I understand that Against Breast Cancer will hold and use the data provided by me for administration purposes, and if I so wish, to keep me informed of its activities and occasional fundraising appeals.

Acknowledgement We will send you an acknowledgement of your gift and if you would also like us to notify the family of the deceased person of your donation, please supply their details below:- Name: Address: Postcode:

Gift Aid Declaration No matter how large or small, as long as you pay income tax and/or capital gains tax, ABC can claim back tax of 28% from the Inland Revenue. Click here for more information on Gift Aid. I am not a tax payer therefore tax cannot be reclaimed on my donation Please treat the enclosed and all future donations as Gift Aid donations NB. Please remember to notify us if you stop paying income tax or capital gains tax equal to the tax we reclaim on your donation.

Please tick if you would like any information on the following: Fundraising  Bankers Order with Gift Aid Leaving a legacy to ABC Give as You Earn The Power of One Big Bang challenge If you prefer not to receive future mailings, please tick this box.