United Reformed Church, Lynton

Standing Order Mandate

To (Name of your bank)
(Address of your bank)
Please pay to: Lloyds TSB Bank plc
  Lynton Branch
  PO Box 1000
  BX1 1LT
for the account of United Reformed Church
Sorting Code 30-90-49
Account Number   
Amount in figures (i.e.50.00) £ 
Commencing date  
and monthly thereafter until you receive further notice from me in writing  
Please debit my account accordingly 
Account to be debited (Name)  
Account to be debited (Number)  
Sorting Code  
My home address is  
Signature  
Date