Standing Order Payment Mandate

To the Manager………………………………………………Bank
Address…………………………………………………………………
………………………………………………Postcode……………….
Account Number …../…../…../…../…../…../…../…../
Sort Code ………/……../……..
Please pay Lloyds Bank Plc Storrington (Sort Code
30-99-93) for the account of Sandgate Conservation
Society account number 02247376 the sum of £5.00
now and the sum of £5.00 annually on the 1st April
each year until further notice quoting reference (your
name and initials) ………………………………………………….
Signature……………………………………….Date …../…../…..
Name (please print) ……………………………………………….
Address………………………………………………………………….
……………………………………………………………………………..
…………………………………..Postcode……………………………

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