Deed of Covenant

I, (full name) _________________________________ of  (address) __________________

_________________________________________________________________________________

hereby covenant with the Trustees of the Charity known as LA SOCIƒTƒ
GUERNESIAISE, of Candie Gardens, St Peter Port, Guernsey, Channel Islands,
that for ____ [note 1] years from the date hereof, or during my lifetime,
whichever period shall be the shorter, I will pay on the ______  day of
__________________  and thereafter on the ______ day [note 2] of
___________________   each year to the said Charity the sum of
£ (amount in words)_____________________________________________ so that
I shall receive no personal or private benefit from any of the said annual
payments or any part thereof.

I am aware that in order to be able to claim the benefit of Section 65 of
the Income Tax (Guernsey) Law 1975,  as amended, I have to make payments
of the amounts and at the intervals specified in this covenant over a period
exceeding three years or during my lifetime, whichever is the shorter.

In Witness whereof I have hereunto set my hand this _______ [note 3] day of

___________________  20______.   Signature: ___________________________ 

Certificate of Witness

I hereby certify that

(a)	I am a member of one of the categories of persons mentioned in
Regulation 5 of the Income Tax (Guernsey) (Form and Manner of Settlements)
Regulations, 1979. [note 4]

(b)	the above named person has signed this Settlement in my presence.

Signature: _______________________ Category of Witness: ______________________ 

NOTES
1.	If the Settlor wishes to claim the benefit of Section 65 of the Income
Tax (Guernsey) Law 1975, as amended, this period must exceed 3 years, i.e. be
not less than 4 years.
2 & 3. The date at note 2 must not be later than the date of the signature of
the covenant at note 3.
4.	Regulation 5 of the Income Tax (Guernsey) (Form and Manner of Settlements)
Regulations, 1979, provides that the following categories of persons may act as 
a witness:
Accountants who, in accordance with the provisions of subsection (2) of Section 78
of the Income Tax (Guemsey) Law 1975, are entitled to appear, in a professional
capacity, before the Authority in connection with an appeal under the Law;
Advocates of the Royal Court; Bank Managers; Douzeniers; Jurats of the Royal Court;
Medical Practitioners; Members of the States of Deliberation; Notaries Public;
Parish Constables.
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BANKER'S ORDER FORM

Please forward this order for registration to the Treasurer at La SociŽtŽ
Guernesiaise, Candie Gardens, St Peter Port, Guernsey GY1 1UG, who will forward it
to the Bankers named therein.

To: (name and address of your Bank)  ____________________________________________

_________________________________________________________________________________

A/C No. ___________________________

Please pay to NatWest Bank PLC. Guernsey, sorting code 60-09-20, for the credit

of La SociŽtŽ Guernesiaise, Account No. 67019609, the sum of £ _________ on

(date)____________________ and annually for _________ years, and debit my/our

account accordingly.