The Dominic Barker Trust
STANDING ORDER

Your Bank or Building Society Details


To the Manager of
..................................................................................		 (name of your Bank or Building Society)


Address
..................................................................................
 
 
..................................................................................
 


Postcode
..................................................................................		  


Name(s) of Account Holder(s)
..................................................................................
 

Branch Sort Code
..................................................................................		  

Account Number
..................................................................................		  
     
Your Address ..................................................................................  
 
..................................................................................		  

Postcode
..................................................................................		  

 

Instruction to your Bank or Building Society

Please pay The Dominic Barker Trust, the sum of

£ ..................................................... (amount in words)

on .................................................... and thereafter every month/year on the same day until otherwise notified.

Signature(s)

 ...............................................................................  

 

Date

 ...............................................................................  

 

For Bank Use only

Please pay The Bank of Scotland plc, 35 Princes Street, Ipswich, Suffolk, IP1 1AE
Sort Code 12-16-39 for the account of The Dominic Barker Trust number 00187540.