Charitable Relief Request Form

Company or organisation *

Property name and number *

Street *

District

City or town *

Postcode *

Billing reference *

Registered Charity Number

Title Mr Mrs Miss Ms Dr Rev Sir

First Name *

Last Name *

Job title *

Email

Phone *

Property name and number *

Street *

District

City or town *

Postcode *

Briefly, what are the objects of the organisation? *

What use is made of the property? *

In the case of a charity shop please indicate what proportion of goods sold consist of donated items?

Are the proceeds from the sale of goods applied for the purposes of the charity?