Termination Form For GIRO, please send the original to Community Chest at 170 Ghim Moh Road #01-02 NCSS Centre Singapore 279621. For other enquiries, please contact us at 1800-210 2600 or
[email protected] A. My Particulars Name (Dr/Prof./Mr/Ms/Mrs/Mdm/Others-Rank:)*________________________________________________________________ Address (New/Existing)*____________________________________________________________________________________ NRIC/PR_NRIC/FIN_________________________________________________________________________________________ Employment Pass No.______________________________________________________________________________________ Contact No.___________________ (HP/HOME)_____________________(O)______________________________________ (Email)
B. I wish to terminate my monthly contribution of $
through the SHARE Programme with effect from (Please allow one month for processing)
(DD/MM/YY).
Termination Reason(s):_____________________________________________________________________________________
Please Tick And Fill-In The Relevant Section. FOR NCSS FINANCE IMMEDIATE ACTION p Part I: GIRO Deduction Only & To Send Back The Original To Community Chest For Our Processing.
My Bank_____________________________________________________Branch_______________________________________
My Account No.
p
FOR COMPANY’S FINANCE/HR IMMEDIATE ACTION Part II: Payroll Deduction Only & To Hand-Over To Your HR/Payroll Section For Their Processing. *Attention: Company Payroll Department To Kindly Assist Employee To Terminate Monthly Donation, Thanks! For Any Increase / Decrease In Amount, Please Advise Employee To Fill-Up The SHARE_Form Again.
Company________________________________________________________________________________________________ **(This form is to be sent to both your company’s payroll department & payroll department is to fax to 6210 2540 – Community Chest) FOR NCSS FINANCE IMMEDIATE ACTION p Part III: Credit/Charge-Card Deduction Only & To Fax Or Sent Back The Original To Community Chest For Our Processing.
My Credit Card Made Through:
p American Express Card
p VISA Card
p Diners’ Club Card
p Master Card
Name of Bank_____________________________________________________________________________________________
Card Number
Donor’s Signature/Thumbprint (As in Bank’s Record)__________________________________________Date___________________ For Official Use only (Donor’s Reference):
COMMUNITY CHEST | The NCSS Fund-raising and Engagement Arm 170 Ghim Moh Road #01-02 Singapore 279621 Tel: 1800-210-2600 Fax: 6210-2540 Email:
[email protected] As fund-raising and other operating costs are covered mainly by Tote Board and Singapore Pools, every dollar raised by Community Chest will be made available to social service programmes under its care.
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