By completing and signing this form, you declare that you:
➢ are willing to act as a trustee of the organisation 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 an offence involving dishonesty or deception
• are currently declared bankrupt (or subject to bankruptcy restrictions or an interim order)
• have an individual voluntary arrangement (IVA) to pay off debts with creditors
• are disqualified from being a company director
• are subject to an order made under section 429(2) of the Insolvency Act 1986
• have previously been removed as a trustee by us, the Scottish charity regulator or the High Court due to misconduct or mismanagement
• have been removed from management or control of any body under section 34(5)(e) of the Charities and Trustee Investment (Scotland) Act 2005 (or earlier legislation)
• are disqualified from being a trustee by an order of the Charity Commission under section 181A of the Charities Act 2011

You also declare that:
➢ the information you provide to the Charity Commission is true, complete and correct
➢ you understand that it’s an offence under section 60(1)(b) of the Charities Act 2011 to knowingly or recklessly provide false or misleading information
➢ your organisation’s funds are held (or will be held) in its name in a bank or building society 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 (CC3)’
https://www.gov.uk/government/publications/the-essential-trustee-what-you-need-to-know-cc3
➢ (if applicable) the primary address and residency details you provide in a charity registration application are correct and you will notify the Charity Commission if they change

Personal benefit
If your organisation pays (or will pay) any trustee for being a trustee OR any trustee or person connected to them for providing goods and services, you declare that this will:
➢ be in the organisation’s best interests
➢ be lawful and authorised
➢ help the organisation carry out its purposes (or be a necessary by-product of it carrying out its purposes)