Pound-Age [vc_row][vc_column] If you are a human and are seeing this field, please leave it blank. Pound-Age Giving Form - (Please Consider Gift Aid) First Name Last Name Address 1 Address 2 City Zip / Post Code Email I would like to give a gift (please choose option below):- One-Off Donation Weekly Monthly Annually I confirm that I would like Age Concern to treat all donations I have made and will make until I notify you otherwise, as gift aid donation. I confirm I pay an amount of income tax and / or capital gains tax at least equally to the tax that the charity reclaim on my donations in the tax year. Standing Order Mandate Name of Bank Bank Address Sort Code Account Number Bank Account Name Please pay to the account of Age Concern Colchester the sum of (figure in £'s):- And thereafter each (please choose frequency): - Weekly Monthly Annually Until further notice Date of First Payment First Name Last Name Address 1 Address 2 City Zip / Post Code Date Beneficiary Details Co-Operative Bank Plc, PO Box 250, Delf House, Southway, Skelmersdale, WN8 6WT Sort Code 08-92-99 Account Number 65487930 Account Name Age Concern Colchester Age Concern Colchester is a registered charity (1142414) and company limited by guarantee. Registered in England and Wales [/vc_column][/vc_row]