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.