Legacy Pledge Form

Title
First name
Last name
Address line 1
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Town
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We are grateful just to know that that you have included Age Concern Sir Gâr in your will. However, if you would like to provide further information about your legacy please use this space:

We would like to keep you informed about Age Concern Sir Gâr initiatives. Please tick the box if you would like us to:
	tell you about our charitable activities