Standing Order Mandate

Beneficiary Details:

Bank: HSBC Bank, 4 Hardman Square, Spinningfields, Manchester, M3 3EB
Recipient Name: Ummah Welfare Trust
Sort Code: 40-20-80 , A/C Number: 00014192

Account to be Debited:

Sort Code: A/C No.:
Name of A/C Holder:
Bank Name & Address:
	Post Code:

Payment Details:

Amount of Payment:

Amount in Words:

FIRST Payment: / /	* LAST Payment: / /
* Tick below (OR immediately on receipt of this order and thereafter on corresponding dates)	* Tick below (OR continue until further notice)

Paid (tick one):

Sign: __________________________________ Date: ____________________

Gift Aid (UK Residents only):

I want Ummah Welfare Trust to treat all donations I have made from the 6th April 2003 to this date and all donations I make from the date of this declaration until I notify you otherwise as Gift Aid donations, which is 25% of all donations made by me to Ummah Welfare Trust. I understand to qualify for Gift Aid I am a UK Tax Payer and whatever I pay in income tax or capital gains tax must at least equal the amount Ummah Welfare Trust will reclaim.

I AGREE

Donation Details:

#	Country	Project	Type (Z/S/L)	£/GBP
1
2
3
4

Contact Details:

Name:		Tel.:
Address:
	Post Code:
Email:

Please ensure you sign and date this copy before sending it to:
Ummah Welfare Trust, 204 Manningham Lane, Bradford, BD8 7DT