CLITHEROE FOOTBALL CLUB

STANDING ORDER MANDATE
To Bank

Name

 Address

Branch

_____________________________

 _______________________
PLEASE TICK RELEVANT BOX:-
 X NEW INSTRUCTION
  Z PLEASE AMEND PREVIOUS STANDING ORDER QUOTING REFERENCE/BENEFEICIARY      
ACCOUNT TO BE DEBITED BENEFICIARY

SORT CODE 

AAAAAA

BANK 

 Barclays Bank Plc

ACCOUNT NUMBER

 ZAAAAAZZ

BRANCH DETAILS 

Clitheroe

ACCOUNT NAME

 _______________ SORT CODE

2 0 0 9 7 2
_______________ ACCOUNT NUMBER

1 0 0 3 7 2 7 3
BENEFICIARY NAME

Clitheroe Football Club

REFERENCE

Weekly Draw

PAYMENT DETAILS

AMOUNT OF FIRST  PAYMENT £4.33

DATE OF FIRST PAYMENT
  ZZ ZZ ZZ

 AMOUNT OF USUAL PAYMENT £4.33

AMOUNT OF USUAL PAYMENT IN WORDS 

Four Pounds - thirty three pence

WHEN PAID  

Monthly

 DATE OF USUAL PAYMENT
XX XX ZZ

COMPLETE EITHER

AMOUNT OF LAST PAYMENT

 £

AND DATE OF LAST PAYMENT
  XX XX ZZ

OR

PLEASE CONTINUE PAYMENTS UNTIL FURTHER NOTICE

 
YES
CUSTOMER SIGNATURE/S
 

          DATE ZZ ZZ ZZ

CUSTOMER CONTACT NUMBER

 
ALL BOXES TO BE COMPLETED FOR THE STANDING ORDER TO BE PROCESSED