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1、. Direct Debit form Internet DonationId like to help The Laser Trust Fund (Moghissi) with a Direct Debit of £_Please state your preferred donation dates: 1st or 15th of each month /quarterly / annuallyOriginators identification number Instruction to your Bank or Building Society to pay Direct D
2、ebit.Please fill in the form in black ink and return to:The Laser Trust Fund (Moghissi)Goole and District HospitalWoodland AvenueGoole DN14 6RXTo the Manager (name of Bank or Building Society)_Name of Account Holder(s)_Account number _Sort code _6For Laser Trust Fund (M) use only. Laser Trust (M) re
3、ference number.Instructions to your Bank or Building Society:Please pay The Laser Trust Fund (Moghissi) Direct Debits from the account detailed in this instruction subject to the safeguards assured by the Direct Debit Guarantee. I understand that this instruction may remain with The Laser Trust Fund
4、 (Moghissi) and if so, details will be passed electronically to my Bank or Building Society.Signature_Date_Banks and Building Societies may not accept Direct Debit instructions for some types of account._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _Your name_Your addre
5、ss_Postcode_Please post all forms to The Laser Trust Fund (Moghissi)The Direct Debit guarantee · This Guarantee is offered by all Banks and Building Societies that take part in the Direct Debit Scheme. · The efficiency and security of the Scheme is monitored and protected by your own Bank
6、or Building Society. · If the amounts to be paid or the payment dates change, The Laser Trust Fund (Moghissi)will notify you 10 working days in advance of your account being debited or as otherwise agreed. · If an error is made by The Laser Trust Fund (Moghissi) or your Bank or Building So
7、ciety, you are guaranteed a full and immediate refund from your branch of the amount paid. · You can cancel a Direct Debit at any time by writing to your Bank or Building Society. Please also send a copy of your letter to us. Giftaid itMake your gift worth more at no extra cost to you! Are you
8、a UK taxpayer? If so we can reclaim approximately 28p from the taxman for every £1 you give to The Laser Trust Fund (Moghissi). Its simple just tick the box to help us support more people with cancer across the UK.Yes! Gift Aid my donation please. I am a UK tax payer and I would like this donat
9、ion, all donations I have made to The Laser Trust Fund (Moghissi) for the six years prior to this year, and all donations I make in the future until I notify you otherwise, to be treated as Gift Aid donations. *I am not a UK tax payer.* For every £1 you donate to The Laser Trust Fund (Moghissi)
10、 in a financial year, you must have paid 28p in income or capital gains tax in the same financial year to qualify for Gift Aid.Data ProtectionYour personal details will be used solely by The Laser Trust Fund (Moghissi) and our authorised agents for research purposes and to advise you of additional f
11、undraising opportunities/news that we think may be of interest. Please tick here if you do not wish this to happen We can, on occasion, raise more funds for people with cancer by allowing other, carefully selected, organisations to contact you. Please tick here if you do not wish this to happen. Please post all forms to The Laser Trust Fund (Moghissi)Goole and District HospitalWoodland AvenueGooleEast YorkshireDN14 6RXThank you*;