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Weston Hospicecare

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
Weston Hospicecare Fundraising Department,
FREEPOST (SWB 502)
WESTON SUPER MARE,
BS23 2ZZ.