B.Hollowell & Son Funeral Directors

Donations

Fill in your details below. Required fields are marked with a

Your Contact Details

1. Name of the person you wish to make a donation in the memory of:
2. Name of charity
3. The Amount your would like to donate £
4. The names we are to record the donation from
   (for example -Fred & John)
5. Your Name
6. Your Address 1
7. Your Address 2:
8. City/Town:
9. Post Code:
10. Country:
11. Contact No:

Gift Aid Declaration

1. If you are a tax payer the charity can reclaim the tax on this donation, this means an extra 28p in every £1 will be given to the charity.
2. I agree that all donations from myself are to be treated as Gift Aid and therefore tax should be reclaimed on these donations. I have paid sufficient tax *for this to be reclaimed by the charity 
3. * sufficient tax means that you must pay an amount of income tax or capital gains tax equal to the amount the charity reclaims on your donation, that being 28p in every £1.

Payment Details 

1. 
   Type of credit card: Visa Visa electron Mastercard Cirrus Solo Switch
2. Name on credit card:
3. Issue number
4. Credit card number
5. Start Date (mm/yy)
6. Expiry Date (mm/yy)
7. CVC Number (3 digit code on the back of your credit card)