## `CHARITY COMMISSION FOR ENGLAND AND WALES` 

## `Trustee Eligibility Declaration` 

```
cSE[COMPLETE][USING BLOCH][ CsrALe][AND][BACK]INKcompleteadditionalforms[f][you]hovemore[than]drustees)
```


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ganisation [name][(Your][organisation] name [as] [it] [appears] in your governing document)<br>Alpio Kofet fourdouon<br>Total number of trustees yourorganisatlon has<br>5<br>Name Tustee1 Name Trustee2 Name Trustee 3 Name Trustee 4<br>SAeAM TIRuNDLE cHACLOona SPAULA RoBERTS get Donagn<br>Signature: Signature<br>Date Date Date<br>**----- End of picture text -----**<br>


- `Working with vulnerable groups Tick this box if your organisation works with vulnerable people (induding children) and you declare that you have: Read and understood the Charity Commission's safeguarding guldance Carried out ali trustee ellgibility checks the law requires and on the basis of those checks are satisfied that the people acting as trustees are both ellgible and suitable to act as trustees of this charlty` 

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Trusteeellgibilityandresponsibility
```

- `By completing and signing this form, you declare that you:` 

   - `are willing to act as a trustee of the organisation` 

```
CorporateTrusteeship
Tick[this][box]ifyourorganisationhas [a][corporate]trustee
(anotherorganisationwhich[acts][as][trustee]suchasalocal
authority)[and][its][directors][are making][this][declaration)]
```

## `Personal benefit` 

   - `If[your][organisation] pays (or wilt[pay) any][ trustee] for belnga trustee OR any trustee[or][person] connected[to][them][for] provlding[gOods and][ services,][you][ decdare] that this will: be[in][the][ organisation's] best interests belawful and authorised help the organisation carry out[its] purposes[(or][ be][a] necessary by-product of it carrying outits purposes)` 

- `named above` 

- `understand your organisation's purposes (objects) and rules set out in its governing document are not prevented from acting as a trustee because you: have an unspent conviction for one or more of theoffences llsted here have an IVA, debt rellef order and/or a bankruptcy order have been removed as a trustee in England, Scotland or Wales (by the Charity Commissionor Office of the Scottish Charity Regulator) have been removed from being in the management or control of any body in Scotland (under relevant legislation) have been disquaified by the Charity Commission are a disqualifled company director are a deslgnated person for the purposes of anti terrorism legislation are on the sex offenders register have been found in contempt of court for making (or causing to be made) a false staternent have been foundgulty of disobedience to an order or direction of the Charity Commission` 

- `You also declare that: theinformation you provide to theCharity Commlsslon true, completeand correct` 

- `you understand that it's an offence under sectlon 60[1)\(b) ofthe Charities Act 2011 to knowingly or recklessly provide fase or misleading informatlon yourorganisation's funds are held (or wltbe held) ln lts namein a bank or bullding soclety account in England or Wales you will comply with your responsibilities as trustees these are set out in the Charity Commission guidance The essential trustee (CCY (if applicable) the prlmary address and residency detals you provide in a charity registration applicatlon are correct and you will notify the Charity Commission If they change` 

```
htps:/lassets.publishing.servlcegOVuk/government
uploads/system/uploads/attachmentdata/flle/820804/
DisqualificationReasonsTablev2.00t
```