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The Maytree Respite Centre Ltd ~ Registered Charity No: 1087668
72 Moray Road, London. N4 3LG


You can give a donation of any size to help Maytree. Regular support made through a banker’s standing order, saves administration costs and gives Maytree the confidence that comes with regular income.    (to cancel, just contact your bank) Maytree thanks you so much for your support.
     (Simply print this page and return the completed form to Maytree at the address above)

                                              

Donor’s Full Name : ________________________________________________________________

Full Address : _____________________________________________________________________

__________________________________________________________________________________

______________________________________ Postcode : _________________________________

(Please write your Bank's full Name and address details below)

To The Manager of (Name of Bank) : ___________________________________________________

Bank's Full Address : _______________________________________________________________

__________________________________________________________________________________

______________________________________ Postcode : _________________________________

Please quote my name on the destination statement and pay to:
Clydesdale Bank, 91 Gresham Street, London (Sort Code No. 82-04-03) for the credit of Maytree A/C 30006583 the sum of :

£ __________________ (figures) _______________________________________________ (words)

each [month] / [quarter] / [year] delete as applicable

Starting on (date) _______|____________________|________ until further notice and debit

Account No.: |___|___|___|___|___|___|___|___| Bank sort code: |___|___|___|___|___|___|


Signature :
_____________________________

GIFT AID ~ If you are a UK tax payer and would like to make your donations worth almost a third extra (28%) at no extra cost to yourself, please tick the box* and then date and sign below.  Maytree can then reclaim the tax you have already paid - that's 28p per £1 donated.

[    ]* I am a UK taxpayer and would like Maytree to treat all donations I have made since 6 April 2000 and all donations I make thereafter, as Gift Aid donations. I understand that I must have paid an amount of income tax or capital gains tax equal to the tax reclaimed on my donation.

Date : _______|____________________|________   Signature : _____________________________