Singer Laren

Machtigingsformulier Singer Laren

Supportersnummer

Salutation This field is mandatory

Voorletters *

Tussenvoegsel

Achternaam *

Straat en Huisnummer *

Postcode *

Woonplaats *

Telephone number

Email address * This email address is incorrect

Kruis hieronder aan wat voor u van toepassing is

Hierbij geef ik eenmalig toestemming om onderstaand bedrag te incasseren via onderstaand IBAN nummer.

Hierbij geef ik Singer Laren toestemming om het bedrag voor een periode van vijf jaar te incasseren via onderstaand IBAN-nummer. Stuur mij daarbij de overeenkomst voor de lijfrente toe, zodat ik gebruik kan maken van het fiscale voordeel volgens de Geefwet 2012-2017.

Ik ontvang graag een factuur van deze incasso voor mijn administratie.

Ik steun Singer Laren voor de renovatie van het museum voor € ... *

IBAN-nummer *

T.n.v. *

Datum

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