Bankers Order Form

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Bankers Order Form

Copts In Need

14 Duke of Wellington Gardens

Wynyard

Billingham

Cleveland

TS22 5FY

Charity Number: 1138357

* Indicates required question

To the Manager: *

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Bank Branch *

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Bank Sort Code *

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Bank Address *

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Post Code *

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Please Pay To:

HSBC Bank PLC

19 Princess Street

Knutsford

Cheshire

WA16 6BZ

United Kingdom

Name of Account: Copts in Need

Account No. 21446193

Sort Code: 40 26 25

On the.....................day of the month and thereafter on the same day of each month *

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Debit my Account Number: *

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the sum of (£) *

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Name *

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Address: *

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Postcode: *

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Submit

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