#### Single charity Uploaded Data

Organisation Name | Demo Organisation Ltd. | HMRC Ref. | HMRCS2
Your own File Ref. | CCS2 | Tax Year |

Authorized Official

Name | Mr Bob Smith | Organization Trustee Name |  | Organization Claim No. |
Post code | AB12 3CD | Overseas Indicator? |  | Phone No. | 020 1234 5678

Charity Regulator

Regulator Name | CCEW | No Regulator? |
Other Regulator |  | Regulator’s Registered No. | 12345

Gift Aid Small Donations Schemes

Are you connected with other Charities purpose for GASDS? | Yes | GASDS Claim Tax Year 1 | 2019 | GASDS donations received Amount 1 | 1000.00
GASDS Claim Tax Year 2 |  | GASDS donations received Amount 2 | 0.00 | GASDS Claim Tax Year 3 |
GASDS donations received Amount 3 | 0.00 | Does your charity have any Community Buildings? | Yes | Previously Over claimed GASDS Payment (deducted from this claim) | 25.00

Other Information

Earliest Gift Aid Donation Date (Included in this claim) | 10/05/ | Adjustment Repayment of Tax Over claimed Amount previously | 50.00
Other information that may be relevant to the claim | Adjustment of 25 pounds to the GASDS |  |