THE MAYTREE RESPITE CENTRE
Registered Charity No: 1087668.  Company No: 4076191

Pledge

I promise to make regular donations to Maytree of £……..…………….each month/quarter/year

starting on …….………………………………………(date).

Full name ……………………………………………………….…………………….……….…...

Address…..…………………………………………………………….…………….……………..

….……………………………………………………………………………………………………

……………………………..………………………………………………..……………………….
 

Signature ……………………..………….                            Date ……………………

I would like to make the donations by Standing Order from my bank (see below), or by cheque made payable to THE MAYTREE RESPITE CENTRE.

Please complete, if applicable, the Banker’s Order below and the Gift Aid Declaration overleaf and return the entire form to:   Maytree, 72 Moray Road, London, N4 3LG.

 Banker’s Order

To: The Manager …………………….……………Bank
 
Address  ………………………………………………………………..………………....………..

………………………………………………………………………………….………………..…....

Please pay Clydesdale Bank, sort code 82-04-03, for the account of The Maytree Respite Centre,

a/c 30006583, the sum of £ ………………………………………………..…

(……………………………………...… in words) on the ..…………..… day of ……………200…..

and thereafter monthly/quarterly/annually until ………………….……...

Name of account to be debited..……………………………………… a/c ……………………….

Signature …………………………………                             Date ……...…………            

Address ………………………………………………………………………………………………..

……………………………………………………………………………………………………..……

…………………………………………………………………………………………………………..

THE MAYTREE RESPITE CENTRE
72 Moray Road, London N4 3LG

Registered Charity No: 1087668. Company No: 4076191

Gift Aid Declaration

I, the undersigned, wish Maytree to treat the donation(s) of £……… enclosed/made on  .../.…./.…   and all future donations made from the date of this declaration as Gift Aid.

Signature ………………………………………….….  Date ……………….……………..

Full Name     ………………………………………………………………………………….

Address (incl. post code)…………………………………….……….……………………...

…………………………………………………...……..……..….…....………………………..

…………………………………………………………………………………………………….

Notes:

• Only sign this declaration if you pay an amount of income tax and/or capital gains tax at least equal to the tax the charity reclaims on your donation in the tax year (currently 28p for each £1 you give). If you are unsure whether your donation qualifies for Gift Aid tax relief ask  your local tax office for leaflet IR.65
• You can cancel this declaration at any time by notifying Maytree, and should do so if in the future you no longer pay tax on your income and capital gains equal to the tax that the charity reclaims
• If you pay tax at the higher rate you can claim further tax relief in your Self Assessment tax return.