Brú na bhFiann, Smith�ield Market, North King Street, Dublin 7, D07 HD72
Tel: 01 485 0666 | Email: info@oneconnect.ie | Web: www.one-veterans.org
SERVING PERSONNEL
SUBSCRIPTION APPEAL FORM
PENSION SUBSCRIPTION APPEAL FORM
OFFICE USE ONLY
DEDUCTION CODE: _______________________ REF: ___________________
OFFICE USE ONLY
DEDUCTION CODE:
_______________________ REF: ___________________
I hereby consent to the deduction of €5.00 per month from my pay for the purpose of
supporting ONE in their efforts in providing accommodation for ex-service personnel.
Such payments are being made solely for my convenience and may be discontinued at
any time. I also accept that all my queries in relation to this deduction are a matter
between ONE and myself and I may cancel this subscription at any time.
I hereby consent to the deduction of €1.25 per week/
€5.00 per month from my pay for
the purpose of supporting ONE in their efforts in providing accommodation for ex-ser-
vice personnel. Such payments are being made solely for my convenience and may be
discontinued at any time. I also accept that all my queries in relation to this deduction
are a matter between ONE and myself and I may cancel this subscription at any time.
NAME: ______________________________________________________________
RANK: ___________________________
NUMBER: _________________________
UNIT: __________________________ AMOUNT: _______________
SIGNATURE: _________________________________ DATE: ________________
NAME: _________________________ PENSION NUMBER: ______________
SIGNATURE: ___________________________ DATE: ________________
Please complete the relevant section and return by post or email to
the postal address or e-mail address above
Organisation of National Ex-Service Personnel
NO IRISH VETERAN LEFT BEHIND
ONE
www.one-veterans.org
