STANDING ORDER MANDATE

To the Manager – Name and address of your Bank or Building Society

Bank/Building Society …………………………………………………………………………………..

Address …………………………………………………………………………………………………………

…………………………………………………………………………….. Post code …..……………….

Please pay Standing Order to

Bank: NatWest Branch: Bournemouth

Sort Code: 56-00-35 Account Number: 28362039

Amount of first payment: £ ____ Date of first payment: __ / __ / __

Amount of regular payment: £ ____

Frequency of regular payment *MONTHLY [Day within month __ ]

Or *Other frequency, please specify

(* delete whichever is not applicable)

**Amount of final payment: £ ____ Date of final payment: __ / __ / __

or **UNTIL FURTHER NOTICE (** delete whichever is not applicable)

Please quote reference (your name): _____________________

Sort Code: ___ – ___ – ___ Account Number: _____________________

Your reference: ___________ Account Name: ________________________

Signed: Date: __ / __ / __