Standing Order Mandate – Non Playing Members
My Bank: …………………………………………………………………………
My Bank's Postal Address: …………………………………………………………………………
Please pay by banker's Standing Order, cancelling all previous instructions regarding this payee:
Pay To - (Bank): HSBC Bank, 221 High Street, Lincoln
Sort Code: 40-28-20
Account Number: 92428024
Account Name: None Playing Members Lincoln RFC
Amount (Figures): £40.00 per year
Amount (Words): Forty Pounds per year
Date of First Payment: 1 September 2007
Payment due day or date: 1 September 2007 or earliest possible thereafter
Frequency: Once only and please 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: …………………………………………………………………………..
SF
