Patrons form
Print this form and, when completed, mail it to Graham Merriam, 1 Hawthorne Terrace, Bagby, Thirsk YO7 2PQ. Call Graham on 01845 597058 with any questions you may have.
YES, please I/We wish to become patron(s) of Sowerby Music to support the Society generally and Music for Life in particular.
Please check Section A, then complete Section B, or preferably complete Section C.
(Please complete Section D if you are a UK taxpayer and you expect to pay tax this year over any tax claim back (currently 28p for every £1 donated).
Section A In any Listing of Patrons, please enter me(us) as
.......................................................................................................
Section B Payment by Cheque
Please accept the enclosed cheque for £............Made payable to
Sowerby Music as my (our) Patron donation for the current year
Section C Bank Standing Order Mandate
To:Name of your Bank...............................................................................
Address of yourBank .................................................................................
...................................................................................................................
...................................................................................................................
Please pay to the HSBC Bank plc in Thirsk (sort code 40-44-12)
for the credit of Sowerby Music(Account Number 41099868)
quoting reference* *please leave blank
The sum of £................(amount in words.....................................................)
commencing...........................................(date of first payment) and thereafter
every month/quarter/year (please delete as appropriate) until further notice.
My/our account to be debited is: Account Name.................................................
Bank Sort Code.....-.....-..... Account Number.....................................................
Signature(s)....................................................................Date..............................
Section D Gift Aid Declaration
Full Name of Donor........................................................................................................
Address.............................................................................................................................
..........................................................................................................................................
Post Code.............................Telephone Number............................................................
I am a UK taxpayer, and I wish Sowerby Music(Registered Charity No.1061719) to claim back the tax on all donations that I make to the Society. I expect to pay an amount of income or capital gains tax this year at a level in excess of that which the society will reclaim, and I will advise the Society if this situation changes in any subsequent years.
Signed.........................................................................Date.......................