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STANDING ORDER MANDATE

To the FISH WELFARE FUND

Return this form to Ruth Lockwood ECHO.  We will send it to your bank having put in the reference required.

 

BANK

BRANCH

SORT CODE

Please pay:

Lloyds/TSB

Forge Court
Reading Road
Yateley
Hants
GU46 7RX

30-91-53

 

BENEFICIARY’S NAME

ACCOUNT NO.

For the credit of:

 

Fish Welfare Fund

03562035

 

AMOUNT IN FIGURES

AMOUNT IN WORDS

The sum of:

£

 

 

Quoting Reference :_______________________ (FWF will put in this reference)

Until you receive further notice from me/us in writing, and debit my/our account accordingly.

THIS INSTRUCTION CANCELS ANY PREVIOUS ORDER IN FAVOUR OF THE BENEFICIARIES NAMED ABOVE, UNDER THIS REFERENCE.

My Bank Name____________________________________________ plc

Bank Address___________________________________________________

________________________________________________________________

Name of Account to be debited:

Start Date        /         / 200

And thereafter annually/monthly on the 1st ………………… each year/month

My Account Number:

My Sort Code:

      

Signature  ______________________________     Date:  __________________

My Name (BLOCK LETTERS PLEASE)_________________________________

My Address _______________________________________________________

_________________________________________________________________

_____________________________________ Post Code ___________________

Email address ______________________________________________________

Please print out this page, complete and return to:

Ruth Lockwood, ECHO Office, 12/16 The Parade, Yateley, Hampshire GU46 7UN