STANDING ORDER FORM
|
| TO THE MANAGER ....................................................................
BANK/BUILDING SOCIETY |
| ADDRESS .............................................................................................................. |
| ......................................................................
POST CODE ........................ |
| Please pay HSBC DINNINGTON Sort
Code 40 - 39 - 07 |
| For the credit of THORNBERRY ANIMAL SANCTUARY |
| Account Number 31691686 |
| |
| AMOUNT (in figures) |
£ ........................... |
| AMOUNT (in words) |
............................................................................... |
| COMMENCING 1st of |
........................... (month) ......................... (year) |
| |
And on the 1st of each month thereafter. |
| |
|
| * UNTIL |
Date ................................................... |
| *OR UNTIL YOU RECEIVE NOTICE FROM ME/US IN WRITING |
| ( * Please delete the option that does not apply) |
| |
|
| PLEASE DEBIT MY/OUR ACCOUNT ACCORDINGLY |
| Name |
|
| Account: Sort Code |
........................................... Account
Number .............................................. |
| Signature(s) |
............................................................................................................... |
| Date |
........ / ........ / 20...... |
| |
|
| Please take/send this form to your Bank/Building Society |
| |
|
