| SOMEBODY CARES PAYROLL GIVING FORM |
| If you would like to support the work of Somebody cares, please print this form out and sent to:- |
Somebody Cares
C/O 67-69 Cowcross Street
London
ECIM 6PN
or fax on 0207 2515970
|
| I would like to give tax free from my pay to Somebody Cares |
| £ ........ per week per month (please tick) |
| I already give to charity by payroll deduction YES NO (please tick) |
| This will be ADDED to existing donations unless otherwise instructed |
| Title Mr / Mrs / Ms ........ Surname .................................. Initials .......... |
| Home Address ..................................................................................... |
| ............................................................ Postcode ................................. |
| Telephone no (in the event of a question) ............................................ |
| Employers Name .................................................................................. |
| Employee No .......................... National Insurance No ......................... |
| Workplace Address .............................................................................. |
| ............................................................ Postcode ................................. |
| I do not wish my details to be passed on to any other organisations |
| Declaration (This must be completed and signed) |
Please deduct a total of £ ............... from my gross pay each pay day as a gift
to charity. I confirm that my gifts to charity 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
or services supplied. |
| Signature .......................................................... Date ........................... |