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Banker's order form
To the Manager _______________________________________________________________
Bank
Branch Address ___________________________________________________________________________
__________________________________________________________________________________
_____________________________________________Postcode_____________________________
Please pay The Abbeyfield
Society the sum of
£_________________________________________________________________________________
(amount in words)
£_________________________________________________________________________________
(amount in figures)
every month/quarter/year* (*delete
as appropriate) on the same day until further notice,
commencing on ________________________________________________
20_______ (date)
and debit my account no: __
__ __ __ __ __ __ Sort code: __ __ __
__ __ __
Name _____________________________________________________________________________
(full name in capitals)
Address ___________________________________________________________________________
___________________________________________________________________________________
_____________________________________________Postcode______________________________
Telephone _________________________________________________________________________
Email _____________________________________________________________________________
Signature ___________________________________________________
Date_________________
For office use: To Barclays Bank (Code 20-03-53) Account
no. 60100277
The Abbeyfield Society Registered charity number 200719
50 Pall Mall, PO Box 15162, London SW1A 1QB
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