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Weston Hospicecare |
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Payroll Giving Form - please print and complete this form
if you would like to take advantage of Give As You Earn by making donations out of your
gross pay. I would like to give tax free from my pay to Weston Hospicecare, £__________ (amount) per Week/Month I do not/do already give to charity by payroll deduction. (If you do already give in this way, the amount will be added to existing donations unless otherwise instructed.) Title Mr/Mrs/Ms _________ Initials__________ Surname ______________________________ Home Address ______________________________________________________________ ______________________________________________________________ Postcode ________________ Employer's Name and Address _________________________________________________ _________________________________________________ Postcode ________________ Employee No. ____________________ N.I. No. ___________________________________ Declaration - (this must be completed and signed please) Please deduct a total of £___________ from my gross pay each pay day as a gift to Weston Hospicecare. I confirm that my total gifts to charity through payroll giving will not exceed the statutory limits in any tax year and will not be used in payment of a covenanted agreement. I understand that only gifts to organisations with charitable status within the UK can be accepted and that no gift can be made as a membership subscription or to pay for goods and services supplied.
Signature__________________________________ Date ___________________________ Please post the completed form to |
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