Standing Order Instruction
To _____________________________ Bank/Building Society
_____________________________ Branch
Please pay the sum of £ _____ to the Bemerton PCC
account at Lloyds TSB Bank plc, Salisbury Branch, Sorting Code 30-97-41,
Account Number 01380004 monthly on _______________ (date) until further
notice.
Please debit my account at:
Bank ___________________________________________
Branch ___________________________________________
Sorting Code–
Account Number ________________________
Signature _________________________ Date _____________