Standing Order Mandate
INSTRUCTIONS TO YOUR BANK OR BUILDING SOCIETY TO PAY A STANDING ORDER PAYMENT
To the Manager......................................................Bank / Building Society
Bank Address..............................................................................................................................
Postcode .......................
Name of account ................................................................................
Account No............................................... Sort Code......................
Please transfer from the above account to the Co-operative Bank:
Garrigill Village Hall, Account no. 65560705, Sort Code: 08-92-99
the sum of £.........(amount in words) .......................................................................pounds
commencing on...............................................and thereafter [annually on that date*] [on the 1st day
of each month*] [delete as appropriate] until this instruction is cancelled.
Using Reference : GVH100-....................................................................(add first initial and surname)
(Signature) ............................................................
(Name):..........................................................
(Address).....................................................................
...................................................................... (Postcode)......................
(Date) ..........................................
DO NOT SEND THIS FORM TO YOUR BANK OR BUILDING SOCIETY