Bognor Regis
01243 864 745
Chichester
01243 77 33 11
Littlehampton
01903 730 666

Donation form

Please complete this form to make a donation to in memory of Tom Daubeny.

All fields marked with an asterisk are required.

Which organisations would you like to donate to?

Donations in memory of Tom are being collected for the following organisations. Select the ones you'd like to donate to.

Organisations
You must select an organisation to donate to.

Donation check

You have entered a custom donation of £0.00. Please tick the box below to confirm this is correct

Please confirm the donation amount is correct

Donation check

You have entered a custom donation of £0.00. Please tick the box below to confirm this is correct

Please confirm the donation amount is correct

Donation check

You have entered a custom donation of £0.00. Please tick the box below to confirm this is correct

Please confirm the donation amount is correct

Donation check

You have entered a custom donation of £0.00. Please tick the box below to confirm this is correct

Please confirm the donation amount is correct

Gift Aid

If you are a UK taxpayer, may be able to reclaim 25p for every £1 you donate. To qualify, what you pay in income tax, the tax on any pension, or capital gains tax, must at least equal the amount claimed in the tax year.

Can you Gift Aid your donation?

Declaration

To Gift Aid your donation, we need you to agree to the statements listed below. We will email you a copy of this declaration for your records.

  • I am a UK taxpayer and am happy for to treat all qualifying donations I have made in the last four years from today’s date, and all donations I will make in the future, as Gift Aid donations.
  • If I pay less income tax and/or capital gains tax in the current tax year than the amount of Gift Aid claimed on all my donations, I understand it is my responsibility to pay any difference.
  • I understand that any tax refund received by will be made at the basic rate. If I pay income tax at the higher or additional rate, and want to receive the additional tax relief due to me, I will include all my Gift Aid donations on my Self Assessment tax return or ask HMRC to adjust my tax code.
  • If my circumstances change and I no longer pay tax on my income and capital gains equal to the tax that reclaims from my donations, I must notify them and cancel this declaration.
  • If I change my name or address, I will notify .
To add Gift Aid you must agree to the declaration

Your details

Your name
Please include area code for landline numbers.
Billing address
Start typing your address to search within the UK. Or you can enter any address manually.
Sharing your contact details

Are you happy for us to share your contact details with Tom's next of kin?

Donations on behalf of

If you would like to show that this donation is on behalf of a group or organisation you can enter it here. Examples of what you might use here: 'Bognor RFC' / 'Julie & John Smith' / 'Everyone at the Kings Head'.

Add a personal message

If you'd like to include a personal message with your donation, you can enter one here. It will be shared with Tom's next of kin after donations close.

What name would you prefer to use?
Display message on memorial?

An online memorial page has been created for Tom.. If you would like to post your message on the memorial, tick the box below. You can post a separate message by visiting the memorial page at any time if you prefer.

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Contact us

We endeavour to respond to every email as soon as we can. You can call at any time of day or night. There will always be someone to take your call.

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