Gift Aid Standing Order Form

Please print out the form below and return completed and signed to:             

EKPCA, Maidstone Masonic Centre, Tovil, Maidstone, Kent. ME15 6QS

Telephone: 01622 766212.    Email:

Beneficiary Charity:             EAST KENT PROVINCIAL CHARITIES ASSOCIATION

Registered Charity Number: 1023859

Donor: (Full names):  ……………………………………………………………………..……………………………..

Donor Address:  ………………………………………………………………………….……………………….…….

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

Post Code: ……………………  Tel. No. ………………........... Email ..............................................................................................................

Declaration:  Please treat all donations I have made since 6 April 2000 and all donations I make thereafter as Gift Aid donations and reclaim the tax thereon.

Tax Requirement:  I, as donor, acknowledge that I will notify you in writing if I no longer pay an amount of Income Tax or Capital Gains Tax equal to the tax that EAST KENT PROVINCIAL CHARITIES ASSOCIATION reclaims on my donations.

Signed: ………………………………………………………………………………   Date: .…..…………………….

Credit to Lodge Name & No. ………………………………………………….………………………………………..

Please apply my donation to:

2014 Festival	Freemasons' Grand Charity	MSF	RMBI
RMTGB	PGM’s Charity	To Be Advised	Other (Supply details below):

(Please tick your choice.  If more than one is indicated donations will be divided equally) 

Charity ..…………………………………………………………………………………………………………………

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

Data Protection Act: If you do not agree to the details of your account with the Association being made available to your Lodge Charity Steward, please tick:    

BANKERS ORDER

To The Manager…………………………………………….. Bank/Building Society

Address: ……………………………………………………………………………………………………………………

              ……………………………………………………………………………  Post Code: ……………………………

Account Name: ………………………………………  Account No.: ……………………………………  Sort code:        -        -  

On the 1^st day of …………….… 20.…... and thereafter at monthly/quarterly/six-monthly/annual** intervals until …………...(month)   20……..,

please pay the sum of £……………….…(figures) ……………….………………………………………………………………………… (amount in words) to:

EAST KENT PROVINCIAL CHARITIES ASSOCIATION.    Account No. 00275845                                  ** Delete as appropriate

Bank of Scotland  (12-20-29), Direct Banking Dept, Teviot House,

South Gyle Crescent, Edinburgh. EH12 9XD

Signature(s) ………………………………………………………………………………………………Date…………………………………….