| To:
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|
Name of your Bank
|
|
|
Branch address
|
|
|
Account name
|
|
|
Account number
|
| Please pay to:
|
Bank
|
Isle of Man Bank
|
Branch
|
East Region
|
| Address
|
PO Box 13, Douglas, Isle of Man IM99 1AN
|
| Sort code
|
55-91-00
|
| Account name
|
Kirk Braddan Millennium Hall Fund
|
| Account no.
|
85361259
|
| the sum of
|
£
|
Amount of instalment
|
| on
|
|
Date of first instalment
|
| and thereafter on
|
|
Date and frequency of subsequent instalments eg. "on the 1st of each month"
|
| until further notice.
Please cancel any existing standing order in favour of the same account.
|
| Date
|
|
Signature
|