Friends of the Hope House

Bank Standing Instruction for Regular Donations
Dear Friend, This form is for Indian citizens wishing to donate a regular amount from an Indian bank account. Please complete the whole form, and take 2 xerox copies. Send or take the original to your bank manager. Send one copy to The Hope House, 16/28, 25th East Cross Road, Gandhinagar, Vellore - 632006, TN, and keep the second copy for your own records. You can cancel this instruction at any time by writing to your bank; we would be grateful if you would also let us know if you do this. A full-year receipt and 80G certificate will be sent each April. Thank you for your support, which means so much to us and to those we seek to serve. Using this form will reduce our administration costs, and enable us to use your money more efficiently. The Hope House

Please write your name: First line of your address: Please enter your Income Tax PAN Number if known This is a donation for Girls Home

and membership no. (if known)

.

(if different from bank account)

Community Outreach Program (COP) The Educational Assistance Program (TEAP)

(Please tick one)

Instruction to your Bank
From Address (Name of Account Holder) (Full address of Account Holder) PIN Code To The Manager (Name of your bank) (Branch Name) Branch Phone: (Branch Address) PIN Code I hereby authorise you to pay from my account number (Enter your account number, or attach a cancelled cheque) Every month / quarter / year (delete those that do not apply) until further instruction from me, to The Hope House – Charitable Trust A/c No. 10404160337 (IFSC SBIN0001618), the sum of Rupees Starting date (figures) [Rupees (day) / (month) / (year). Cash Credit (tick one) (in words)] Fax:
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Account type: Savings Bank

Current Account

I hereby declare that all the particulars given above are correct and complete. Signed (Account holder’s signature) Date effective / / .

Bank: Please quote the name of the donor and the reference narrative field with each remittance.

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