Give As You Earn
Deduction from
Salary
I, the undersigned, authorise deductions to be made from my salary, with effect from the first day of :
and until further notice, the sum of :
|
£3
|
£5 |
£ | (INSERT AMOUNT) |
To be paid through the Services authorised Give AS You Earn Scheme to the Ambulance Services Benevolent Fund, Registered Charity No: 800434, Registered GAYE No: 000101126
I understand that I can cancel
this agreement by giving two months notice, in writing, to the Secretary of the
Ambulance Services Benevolent Fund or my Payroll or Human Resource
manager.
Surname
..First
Name
Signed
..Date
Ambulance
Service
Station /
Department
..
Grade or
Position
...
Home Address
.
. Post
Code
Pay No (if
known)
Ambulance Services
Benevolent Fund
Registered
Charity No: 800434
c/o
Cherith, 150 Willingdon Road, Eastbourne, East Sussex. Tel: 01323
721150
www.asbf.co.uk