Standing Order Form

Yes, I want to help Sahir House with a regular gift by standing order

Please pay Sahir House;

[ ] £1 [ ] £2 [ ] £5 [ ] £10 [ ] Other £ ___ a month starting on (date) _____/_____/_____

Please pay:

The Manager		CCLA Investment Fund
(Bank/Building Society name)		COIF Charity Funds
Address		80 Cheapside, London
Postcode		EC2V 6DZ
Account Number:		21851321 Ref.015700001C
Sort Code:		15-10-00

Your bank details
Name of Bank		____________________________________________________
Address		____________________________________________________
		______________________________________________
Postcode		______________
Account number		___________________________ Sort Code______________
Your contact details
Name		____________________________________________________
Address		______________________________________________
		______________________________________________
Postcode		______________
E Mail		____________________________________________________
Signature		____________________________ Date __________________

[ ] Please Gift Aid my donation so Sahir House can get better value from my donation*

[ ] I do not want to be kept informed about Sahir House events or information

Data Protection information

Your personal details are only required to claim Gift Aid if you choose not to receive Sahir House information. We will not pass your information on to any third party.

txt *Using Gift Aid means that for every £1 that you donate, Sahir House can recover an extra 28p from the Inland Revenue. So the value of your donation is increased at no extra cost to you. Just tick the Gift Aid box on the form. To qualify for Gift Aid what you pay in income tax or capital gains tax must at least equal the amount we will claim on your donation.

Please return this form to Sahir House PO Box 11 Liverpool L69 1SN