Standing Order Form
| I/We wish to offer long term support to Leicester and Leicestershire Animal Aid Association by making a regular donation of £............................................ * Every week/fortnight/month/quarter/year (*Please indicate) Starting on (date): ................................................. until further notice Surname: ............................................................................................ Other Names: ....................................................................................... Full Postal Address: ................................................................................ .............................................................................................................. .............................................................................................................. .............................................................................................................. .........................................................Postcode: ..................................... E-mail: .................................................................................................. To: The Manager (Bank/Building Society Name): .............................................................................................................. Address: ................................................................................................ .............................................................................................................. .............................................................................................................. .............................................................................................................. .............................................................................................................. ....................................................................... Postcode: ...................... Account Name: ...................................................................................... Account No: ................................................... Sort Code: ...................... Signature(s): ......................................................................................... Date: .................................................................................................... Please pay to: Leicester and Leicestershire Animal Aid Association Account No: 01313065 Sort Code: 30-94-97 Lloyds TSB, 7 High Street, Leicester, LE1 9FS Ref. : ..............................(LAA Office use only) GIFT AID DECLARATION FORM - INCREASE YOUR DONATION AT NO COST TO YOURSELF! Declaration: I am a UK taxpayer. Please reclaim the tax on this and all future donations (currently 28p for every £1 donated). Signature: ....................................................... Date: ............................ (Please remember to tell us if you cease paying tax or change address) Please complete this form and post to LAA, Elmwood Farm, Forest Road, Huncote, Leicestershire, LE9 3LE. Thank you very much for your help |