HOUSE TO HOUSE COLLECTIONS ACT 1939 - RETURN
Form of Account of Expenses, Proceeds and Application of Proceeds of Collection of Money
(A Statement on this form must be completed and forwarded to the Licensing Section, Surrey Heath Borough Council, Knoll Road, Camberley, Surrey, GU15 3HD within ONE MONTH of the expiration of the Licence)
Promoter
*
Address of Promoter
*
Street Address
Street Address Line 2
Town/City
County
Post Code
Purpose of Collection
*
Area to which account relates:
*
Period to which account relates
*
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Proceeds of Collection (All amounts to be entered GROSS)
*
£0.00
From collectors as in lists of Collectors:
And amounts attached hereto:
Bank Interest:
Other Items (if any):
TOTAL
If you have entered an amount against 'Other Items' - please add details here:
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Expenses and Application of Proceeds
*
£0.00
Printing and Stationary:
Postage:
Advertsiing:
Collecting Boxes:
Other Items (if any):
Disposal of Balance:
TOTAL:
Please enter details of 'Other Items' here:
Disposal of Balance details:
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Declaration
CERTIFICATE OF PROMOTER
*
I certify that to the best of my knowledge and belief, the above is a true account of the expenses, proceeds and application of the proceeds of the collection to which it relates.
Date
*
/
Month
/
Day
Year
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Email address of Promoter
example@example.com
Certificate of Auditor
Please provide details of your Accountant or Independant Responsible Person who we can contact for confirmation that the above is in their opinion a true account of the expenses, proceeds and application of the proceeds of the collection to which it relates.
Email address of Auditor
*
example@example.com
Privacy Statement
Details of Surrey Heath Borough Council’s Privacy Notice can be found
here
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