Please use this form to create your new donation.
Please be sure to complete all sections so that your donation can be processed as quickly as possible.
Your Employer's Details
Finally, your charity may wish to write to you to say thank you for your donation, if you do not wish them to then please tick here
The data supplied on this form will be used to enable your donation to reach your chosen charity/ies. In order that your
instructions can be acted on, your details will be passed to HM Revenue & Customs registered Payroll Giving Agent, with
whom your employer has contracted, who will forward your donation to your chosen charity/ies. HOH will record the details
shown on this form for administration purposes.
By submitting this form you confirm that this pre-tax donation is made through your employers' Payroll Giving scheme, and will not be included in Gift Aid claims.
Form security information
Helpline: 01433 621882