BANKER'S ORDER
To the Manager . . . . . . . . . . . . . . . . . . . . . . . . . . Bank plc
Address . . . . . . . . . . . . . . . . . . . . . . . . . .
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Please pay to the account of
The Muscle Help Foundation, Registered Charity No 1096716
at Lloyds TSB Bank plc, 4th Floor, Hay's Lane House, 1 Hay's Lane, London SE1 2HA
Sort Code 30-94-81 Account No 01720428
the sum of . . . . . . . . . . . . . . . . . . . . . . . . . . . . (figures)
( . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (in words)
on the . . . . . . . day of . . . . . . . . . . 20 . . . .
and on the same date in each succeeding month / quarter / year, until further notice.
Please debit my account number: . . . . . . . . . . . . . . . . . . . with each payment made. This instruction cancels any previous order in favour of the beneficiary named above and remains in force until you receive further notice from me in writing.
Date: . . . . . . . . . . . . . . . . . . .
Signature: . . . . . . . . . . . . . . . . . . .
Address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .