SmartGiving Payroll Giving scheme Individual joining form Question Title * 1. Your Contact info Name Address Address 2 City/Town Postal Code Country Email address Phone number Question Title * 2. Your Employer info Company name Company contact name Address Address 2 City/Town Postal Code Country Payroll department email address Payroll department phone number Question Title * 3. Please tick as appropriate: Please note where the replacement box is ticked, existing instructions will be deleted andreplaced. First time request Additional to an existing instruction Replacement of existing instructions Question Title * 4. Employee Number Question Title * 5. National Insurance Number Question Title * 6. Donation options: Please select your favoured option and complete as appropriate: A - Charity Account - I wish to open a SmartGiving Charity Account and make my donations online B - I already have a SmartGiving Charity Account C - Monthly donation to charity(s) - please complete question 7 and /or 8 below: Option B - Please specify Charity Account number Question Title * 7. Option C - Charity 1) Charity Name Charity Number (if known) Donation amount £ Question Title * 8. Option C - Charity 2) Charity Name Charity Number (if known) Donation amount £ Question Title * 9. Please deduct a total of £….. from my gross salary each pay day as a gift to charity.I understand that only gifts to organisations with a charitable status within the UK can be accepted and that a gift cannot be made as membership or in payment of goods or services supplied. *An admin fee may be applied. Question Title * 10. Declaration Agree Disagree Submit