Payroll Giving

Payroll Giving Donation Form

How it works

By simply completing this form, you can choose to support
any charity of your choice, directly from your pay.

Pay no tax

Because the donation is taken from your gross pay, every pound you give
will only cost you 80p, or 60p if you are a higher rate tax payer.

You donate  
Cost to you as a 20% tax payer  
Cost to you as a 40% tax payer  
Payroll Giving Logo
Source code: PGA [Agency: ]
 Please select donation type
 How often are you paid?
Please select your payment frequency :
 Which tax band are you in?
Please select your tax band :

Click here to read the Tax Band explanation

I would like to give a regular tax-free donation from my pay to:
Charity Name :
Charity Name :
Charity Name :
+ More Charities
Charity Name :
Charity Name :
Charity Name :
Total amount to be deducted from your Gross pay each pay day: £ 0.00
Cost to you from your Net take home pay: £ 
Total amount your chosen charity(ies) will receive : £ 
Cease Payments : I wish to cancel all payments
DECLARATION: By signing this form you are confirming your understanding that no further tax is recoverable on this gift and understand that only gifts to organisations with charitable status within the UK can be accepted and that no gift can be made as a membership subscription or to pay for goods or services supplied.
First name:
Last name:
Email address:
Confirm e-mail address:
Telephone number:
Mobile number:
Your home address
Address line 1:
Address line 2:
Town / city:
Your employment details
Employer's full name :
Employee/staff number: (Normally found on payslip)
National Insurance Number:
Workplace Postcode:
Work address line 1:
Work address line 2:
Work town / city:
Work county:
Your digital signature
Enter your full name as confirmation of the completed form:
No part of your donation is taken by us in commission. We (Payroll Giving in Action) receive a fee from our member charities based on results.
Please Note: You should allow up to 6 weeks before the donation will show on your payslip. Your employer's Payroll Giving Agent (Registered Charity) charge a monthly administration fee of no more than 25p or 4% per monthly deduction to cover the cost of processing.
Data protection
MARKETING: Opting in to receive charity marketing communications means you can see how your chosen charity/ies use your donations to help provide their services. 'Marketing' consists of any communication which promotes a charity or its values, so could be anything from a newsletter to a specific appeal.

Using the boxes below, please indicate which channels your charity may use to send you marketing. Ticking as many boxes as possible gives your charity the option of choosing which way works best for them. If you do not tick any, then you may receive no contact at all from your charity, not even an acknowledgment of your donation. We will never share your details without consent.
PRIVACY: If you have opted to receive any form of marketing from your chosen charity/ies then we, Payroll Giving in Action Ltd will pass on the relevant contact information you've provided to them.

In order for your donation to be processed we, Payroll Giving in Action Ltd, must share data with your Employer's Payroll Department and chosen HMRC registered Payroll Giving Agent. Your Employer has a contract with the Payroll Giving Agent who are responsible for passing your donated money onto your Charities. If your employer has an existing relationship with another named organisation, we may need to share your details with them to carry out the processing of your donation. Some charities use a Third Party for support services, with whom they are contracted, and with whom they may share your data for processing purposes. To view your chosen charity's privacy statement, please visit their website.

Payroll Giving in Action Ltd will store your data in line with our internal Data Protection Policy (which you can find ) for a period of 7 years, after which time we will delete.

Please note you are not able to remain anonymous from your Employer's Payroll, or from their chosen Payroll Giving Agent.

You may be contacted in the event of a specific query needed to resolve the processing of your data for the purposes of these instructions. Our full Privacy Policy is detailed at
Form security information
Your IP address:
Time/date stamp: 19 Aug 2019 18:28:19
SSL encryption: GeotrustThis page is protected with a Geotrust SSL with up to 256-bit encryption. Your confidential information cannot be viewed, intercepted or altered.

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Giving Online is the online tool for Payroll Giving in Action.

If you are having difficulty with this form email [email protected] or call 01271 344360.

Payroll Giving in Action - Millennium House, Brannam Crescent, Barnstaple, Devon EX31 3TD