Set up a regular donation

Title

First name

Surname

Address line 1

Address line 2

City/town

County

Postcode

Telephone number

Email address

I would like to make a regular donation to Age UK Solihull by direct debit of: £5 £10 £25 £50 £100 Other amount (please specify below)

If other amount, please specify

I would like my donation to be taken:

Starting on the: 1st 15th

of the (month and year)

And I wish for the same sum to be taken on the same date with the frequency indicated above until further notice.

Account details

Account name

Account number

Sort code

Gift Aid declaration

If you are a UK taxpayer, please say 'yes' to Gift Aid. Gift Aid can be reclaimed by us from the tax you pay for the current tax year. It means for every £1 you donate Age UK Solihull can claim an extra 25p from HM Revenue & Customs.

Yes, I would like Age UK Solihull to Gift Aid my donations. I am a UK taxpayer and understand that if I pay less income tax and/or Capital Gains tax in the current tax year than the amount of Gift Aid claimed on all of my donations, it is my responsibility to pay any difference. I am not eligible for Gift Aid

You can change or stop your donation at any time. Please email us on fundraising@ageuksolihull.org.uk or call 0121 704 7842 if you would like to discuss this.

Keeping in touch

We may contact you by email, post or text with information about our work, including fundraising, events and campaigns. You can opt out at any time, including by using the unsubscribe link in our messages or by contacting us. We will never pass on your details onto any other party without your permission.

We like to send our Age Angels a Christmas card or other holiday card each year to express our thanks for supporting us. Please let us know if would prefer to receive a card for a holiday other than Christmas, or you would like to be thanked in a different way..