Standing Order Mandate – Countess Owners Association

 

 

Please complete and send to your bank branch: -

 

The Manager: ……………………………………………

Branch Postal Address:.…………………………………...

 

…………………………………………………………………

Please pay by Banker's Standing Order, cancelling any previous instructions regarding this payee:

 

Pay To:    Lloyds TSB Bank plc. Ellesmere Port Branch

 

Sort Code:   30-12-96                           

 

Account Number:  01295795

 

Account Name:  Countess Owners Association

 

Reference (boat name)           ………………………………..

   

Amount              £17.00 (Seventeen Pounds Sterling Only)

Date of First Payment: Immediately                                           Frequency:   Annually 3rd January

Until further notice and debit my account accordingly: -

 

Name of my account:…………………………………….

 

Sort code:……………………Account number:…………………………………

 

I hereby authorise you to set-up this standing order payment on my account:

 

 

Signed:......................................................…………...Date:...............................….

 

Name: (Block Capitals):................................................................................……...

 

Address:………………………………….     Telephone:…………………….   

                                               

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