BANKERS ORDER FORM Please help Somebody Cares by Standing Order. Regular donations help us plan our funds. Somebody Cares C/O 67-69 Cowcross Street London ECIM 6PN or fax on 0207 2515970 I would like to donate £ .............. each month Starting on (insert date) ................. until further notice Title Mr / Mrs / Ms ........ Surname .................................. Initials .......... Home Address ..................................................................................... ............................................................ Postcode ................................. Gift Aid Declaration (increases donation by approximately a third) Please treat all my future donations as Gift Aid Donations. My tax status is: NON ....... BASIC ...... HIGHER...... Please note: To reclaim the tax on your donation you must be paying income or capital gains tax equal to the amount to be reclaimed Signature .......................................................... Date ...........................    I do not wish my details to be passed to any other organization   Bank Details Title ........ Surname .................................. Initials .......... Branch Name ..................................................................................... Branch Address ..................................................................................... ............................................................ Postcode ................................. Sort Code ...................... Account No .............................. Please deduct £ .......... each month Commencing on ................. until further notice Signature .......................................................... Date ........................... Thankyou Charity Bank Details SOMEBODY CARES UNITY TRUST BANK NINE BRINDLEYPLACE 4 OOZELLS SQUARE BIRMINGHAM B1 2HB SORT CODE: 08-60-01 ACCOUNT NO. 20062785 Please send to Somebody Cares c/o 67-69 Cowcross Street London EC1M 6PU (not to your bank)

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