Standing Order Form

Please complete this form and send to your bank

Regular Payments Form

Please set up a new Standing Order.

Your Account Name:  _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Sort Code:       _   _     _   _      _  _           Account Number :    _   _   _   _   _   _   _   _

Please complete relevant section below and then sign and date the form,

Beneficiary Name: (Who you want to pay)                       Gayton PCC Rectors Expense Account

Sort Code :                                                                               20 – 46 - 65

Account No.Reference:                                                          80398047
 

Amount of first payment                                                       £……………………..
 

Amount of usual payment                                                    £……………………..
 

Frequency of Payment

(Weekly/Monthly/Annually)                                                 ……………………….
 

Date of first payment (dd/mm/yy)                                        ……………………….
 

Date of last payment (dd/mm/yy)                                        ……………………….

or please continue until further notice

Date of usual payment (dd/mm/yy)                                     ……………………….

All entries must be completed in order for your request to be processed
 

Date: (dd/mm/yy)                                                      ………………………………………………………..

Customer Signature(s):                                              ………………………………………………………..
 

                                                                                         ………………………………………………………..

Customer Contact Telephone Number :                  ………………………………………………………..

Where signing mandate dictates both / all to sign, all parties must authorise instruction.