Charities only (do not complete unless the dissolved company was a charity) (a)The company was a charity registered number (5). (b) I/we can confirm that any grant made by the Treasury Solicitor will be paid to (6) (the Recipient”). The Intended Recipient is a charity registered under registration “Intended number (7). (c) I/we confirm that the constitutions of both the Intended Recipient and the company permit the discretionary grant to be paid to the Intended Recipient. (d) I/we confirm that the Charity Commission for England and Wales have no objections to the discretionary grant being paid to the Intended Recipient. Payment I/we would like the cheque to be made payable to (8) I/we make this solemn declaration conscientiously believing the same to be true and by virtue of the Statutory Declarations Act 1835. Signed: Full Name: Declared at (9) this day of 201 before me (10) Full Name: Solicitor/Commissioner for Oaths Please insert the following information: full name(s) full address(es) company name company number charity registration number Recipient charity Recipient charity registration number Full name of Payee business name and address of Solicitor/Commissioner for Oaths signature of Solicitor/Commissioner for Oaths
Charities only (do not complete unless the dissolved company was a charity) (a)The company was a charity registered number (5). (b) I/we can confirm that any grant made by the Treasury Solicitor will be paid to (6) (the “Intended Recipient”). The Intended Recipient is a charity registered under registration number (7). (c) I/we confirm that the constitutions of both the Intended Recipient and the company permit the discretionary grant to be paid to the Intended Recipient. (d) I/we confirm that the Charity Commission for England and Wales have no objections to the discretionary grant being paid to the Intended Recipient. Payment I/we would like the cheque to be made payable to (8) I/we make this solemn declaration conscientiously believing the same to be true and by virtue of the Statutory Declarations Act 1835. Signed: Full Name: Declared at (9) this day of 201 before me (10) Full Name: Solicitor/Commissioner for Oaths Please insert the following information: full name(s) full address(es) company name company number charity registration number Recipient charity Recipient charity registration number Full name of Payee business name and address of Solicitor/Commissioner for Oaths signature of Solicitor/Commissioner for Oaths
DG2_application_form_and_statutory_declaration.docx