St Mungo’s, Midshire

Confidential Income Declaration Form

Please tick the box that is nearest to your total income from all sources after tax.Please tick one box only.

My total income is

Per Year / Per Month / Per Week
A / No income / No income / No income
B / £1 – £5,000 / less than £417 / less than £96
C / £5,001 – £10,000 / £418 – £833 / £97 – £192
D / £10,001 – £15,000 / £834 – £1,250 / £193 – £288
E / £15,001 – £20,000 / £1,251 – £1,667 / £289 – £385
F / £20,001 – £27,500 / £1,668 – £2,292 / £386 – £529
G / £27,501 – £35,000 / £2,293 – £2,917 / £530 – £673
H / £35,001 – £42,500 / £2,918 – £3,542 / £674 – £817
I / £42,501 – £50,000 / £3,543 – £4,167 / £818 – £962
J / £50,001 – £60,000 / £4,168 – £5,000 / £963 – £1,154
K / £60,001 – £70,000 / £5,001 – £5,833 / £1,155 – £1,346
L / £70,001 – £80,000 / £5,834 – £6,667 / £1,347 – £1,538
M / more than £80,000 / more than £6,667 / more than £1,538

Explanation

As well as supporting the work of your local church and clergy, a part of which you give to your church goes towards the costs of other ministers working in the diocese. These costs include stipends, pensions, training and housing. This common parish share also supports diocesan wide ministries, support and administration.

Across the diocese we want to make as fair and proportional an assessment as possible of each parish’s contribution to this common share. To achieve a genuinely proportional assessment, we need together to take account of the actual income of those who are in active membership of each of our parishes.

A fuller explanation of this can be found in your churchwarden’s letter and the accompanying leaflet.

Notes

  1. Please place this form in the sealed box in Church marked INCOME
  2. If you are unable to take the forms to Church yourself, place this form in a sealed envelope, marked INCOME, and send it to one of the Churchwardens, or get someone to take it to Church for you.

Thank you for your help in completing this form.

Remember: the separate forms and boxes are to
maintain confidentiality. Thank you for your help.