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Instruction to your Bank or Building Society to pay by Direct Debit Please fill in the whole form including official use box using a ball point pen and send it to: Originator's Identification Number Poppyscotland 6 7 1 6 0 0 New Haig House Logie Green Road FOR THE EARL HAIG FUND SCOTLAND OFFICIAL USE Edinburgh This is not part of the instruction to your Bank or Building Society. Name ______________________________________ EH7 4HR Address ____________________________________ ___________________________________________ Scottish Charity No SC014096 Poppyscotland is a company limited by guarantee. Registered in Scotland No 194893 Name(s) of Account Holder(s) Town __________________ Postcode ____________ Phone _____________________________________ Email ______________________________________ I would like to set up a Direct Debit of: Bank/Building Society account number £ Monthly/Quarterly/Annually Please debit my Bank/Building Society account on : 1st 15th Branch Sort Code Instruction to your Bank or Building Society Please pay Earl Haig Fund Scotland 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 Name and full postal address of your Bank or Building Society with Earl Haig Fund Scotland and, if so, details will be passed To: The Manager Bank/Building Society electronically to my Bank/Building Society. Address Signature(s) Postcode Date Reference Banks and Building Societies may not accept Direct Debit Instructions for some types of account This guarantee should be detached and retained by the Payer. 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 or Building Society. If the amounts to be paid or the payment dates change Earl Haig Fund Scotland will notify you 10 working days in advance of your account being debited or as otherwise agreed. If an error is made by Earl Haig Fund Scotland or your Bank or Building Society, 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. Make your donation worth more with Gift Aid and Poppyscotland will continue to receive an extra 28p from HM Revenue & Customs for every £1 you donate until 5 April 2011 and 25p thereafter. I confirm that I pay income tax in the UK. I wish Poppyscotland to reclaim tax on this donation and all donations in the future until I notify you otherwise. (please tick box) Data Protection – Poppyscotland would like to keep in touch with you regarding all aspects of our important work. If you would prefer not to hear from us at all in the future other than regarding your regular donation, please tick here.
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