Lump sum payment to a charity established in Jersey
Your full name:
Have made a single payment to:
The net sum of:
Tax reference of donor:
Name of charity:
and that all the condions below have been sased.
is resident in Jersey for tax purposes on the date
the payment is made
has paid, or will pay, income tax at least
equivalent to the tax in respect of the gi (the
details of the donaon should be included on the
Complete the boxes below if the form has been signed on behalf of a company.
is made in money and is not subject to a
condion that any part of it can be repaid
is not due under a deed of covenant
is not part of an arrangement to benet the
donor, the donor’s family or an individual or
company connected to the donor
is not linked to the acquision of property by the
charity except by way of a gi
is at least £50 and when added to other lump
sum donaons by the donor or persons
connected with the donor, does not total more
than £500,000 in any one calendar year.
This form needs to be sent to the charity’s administrator when the donaon is made.
For Charity’s use
Charity tax reference:
Taxes Oce use
(amount in words)