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By completing this form you agree to the following:

I confirm I have paid or will pay an amount of Income Tax and/or Capital Gains Tax for each tax year (6 April to 5 April) that is at least equal to the amount of tax that all the charities or Community Amateur Sports Clubs (CASCs) that I donate to will reclaim on my gifts for that tax year.  I want Dolen Cymru [reg charity No. 1143448] to reclaim the tax on membership, and tax I have already paid since April 2000, and on every donation I may give in the future.