SPECIAL PURPOSE FUNDS REQUESTS
SPF003 – BACS FORM (INCOME DIRECT INTO BANK)
For the fundholder/other contact to complete
Fund Name:
……………………………………………….
Fund Number:
……………………………………………….
Company:
……………………………………………….
Donation Amount:
……………………………………………….
Date of Anticipate Funds: ……………………………………………….
Purpose of Donation:
……………………………………………….
(i.e. donation, course/training fee, sponsorship, research)
If company is supporting research, please be aware that an accompanying letter is required to state that
it is not a commercial project and that the donation is given freely without any stipulations.
Signature of Fundholder/Other Contact: ……………………………….
Date:
………………………………...
For The Charity to complete
Bank: …………………………………………………………………………
Account Name: ………………………………………………………………
Account Number:
…………………………………………………
Sort Code:
…………………………………………………
The income must be a donation, freely given with no restrictions and made towards it charitable
objectives
Once complete, send a copy of this form to deborah.meredith@bartshealth.nhs.uk. The SPF
Manager will email you back this form with the bank account details included.
Please ensure the remittance advice from the company is sent to The Charity along with this
completed form.
Without any notification the finance team will not be able to allocate the income to the correct
fund. This may mean the income might have to be returned to the company making the donation
or the money being paid into The Charity General Fund.