Your monthly donation

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Thank you for choosing to set up a monthly donation. Your regular donations will help people struggling to cope.
£ a month
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We’ll keep you up-to-date with our latest news, appeals and projects.
We’d like to be able to call you to tell you how your support is helping and about other ways to get involved. Please only give us your phone number if you’re happy for us to contact you by phone.
Instruction to your bank or building society to pay by Direct Debit

Samaritans
The Upper Mill, Kingston Road, Ewell, Surrey KT17 2AF

Service User Number: 837024

e.g. in the format: 12-34-56
I would like my Direct Debit to start on *
Format: 23/03/2017

Instruction to your Bank or Building Society

Please pay Samaritans Direct Debits from the account detailed in this instruction subject to the safeguards assured by the Direct Debit Guarantee. I understand that this instruction may remain with Samaritans and, if so, details will be passed electronically to my bank/ building society.

I confirm that I am the account holder of a UK bank or building society account and am the only person required to authorise debits from this account. (If you are not you can print and complete a paper mandate instead.)
Gift aid
If you are a UK taxpayer, you can increase the value of your donation by 25% under the Gift Aid scheme – at no additional cost to you – just by ticking the box below.
I am a UK taxpayer and would like Samaritans to reclaim the tax on all donations I have made in the last four years and all future gifts of money that I make to be Gift Aid donations. I understand that if I pay less Income Tax and/or Capital Gains tax than the amount of Gift Aid claimed on all my donations in that tax year then it is my responsibility to pay any difference.

Please let us know if your tax circumstances or name/address change so we can update our records.
How would you like to hear from us in future?
We would love to stay in touch and let you know how your fantastic support is helping Samaritans and to keep you updated on our latest projects and fundraising appeals through the post. We may also contact you by phone or email if you have given us permission to do so.

If you’d prefer not to hear from us, please let us know by emailing supportercare@samaritans.org or calling us on 03709 00 00 32.

As a responsible organisation, and in accordance with the 1998 Data Protection Act, we will always handle your information in the strictest confidence and we will never share your details with third parties.

You can view our full Data Protection policy here.