Standing Order Form to the Parish Church of St Andrew, Chippenham
(Registered Charity 1131163)
Please print this form off, complete it and return it to Ros Harford or Wendy Reeves, address below
Title Full Name
Post Code Tel. No.
I would like to pay my contribution by (tick applicable)
a. Standing Order from my bank or building society which I will arrange via the internet
b. Standing Order from my bank or building society and I have completed the form below.
Gift Aid Declaration:
REGULATIONS REQUIRE DECLARATION TO BE CURRENT AND ANY CHANGE NOTIFY GIFT AID OFFICER, WENDY REEVES
If you pay any income tax, even on bank or building society interest, please sign the following declaration in order for the Church to recover the tax paid.
I want the Church to reclaim tax on all my donations and note that I should advise the Church if I do not pay an amount of tax that at least equals the tax deducted from this donation.
Don’t send direct to your Bank, Ros/Wendy will collectively post them off to the Banks – If you can email, then please complete the necessary information on line or by post and forward to:
Giving Officer: Ros Harford email@example.com 101 Studley Hill, Studley, Calne SN11 9NL
or Gift Aid Officer: Wendy Reeves firstname.lastname@example.org 269 London Road, Chippenham SN15 3AS
Standing Order fill in your bank details
To the Manager, (Bank or Building Soc.)
Please pay to the Parochial Church Council of St. Andrew, Chippenham at
HSBC Bank plc, 2 Market Place, Chippenham, Wiltshire, SN15 3HE;
Sort Code 40-17-17;
Account Number 71172948
the sum of £ (figures) (words)
commencing on the first day of ____________ and a like sum every month / quarter / year until December 2020 and debit my account with each payment when made.
This is a (tick applicable box) new instruction; / amended instruction, please cancel previous instruction in favour of the above payee.
This Standing Order Form will only be seen by the Giving/Stewardship Organiser and Gift Aid Officer, who will, if appropriate, be in touch to make any necessary arrangements. (Standing Order Form April 2020)