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To make a donation by cheque, print this page, fill it in, and send it with your cheque to Action for Tinnitus Research, 330-332 Gray's Inn Road, London WC1X 8EE.

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	Please reclaim tax on all donations I make to Action for Tinnitus Research from 6 April 2000 until further notice. Please note that you must pay an amount of income tax or capital gains tax at least equal to the tax we reclaim on your donations in any particular year (currently 28p for every £1 you give).

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