BANKERS' ORDER

To the Manager,

Name of your Bank    __________________________________________________

Address of your Bank _________________________________________________

___________________________________________________________________

___________________________________________________ Post Code: ______

1. Please CANCEL all existing Standing Order Instructions in favour of the Shropshire Ornithological Society forthwith.

2. Please ACTION the new Standing Order Instructions as follows:

Please Pay:   Shropshire Ornithological Society

at:                 Barclays Bank plc.   23 Church Street, Wellington, Telford.

Account No:.......................        (TO BE COMPLETED BY SOS)

Sort Code:........-...........-..........  (TO BE COMPLETED BY SOS)

The Sum of:

£________________(Amount in figures)

£__________________________________________(Amount in words)

Commencing NOW and thereafter annually on and from 1st January _______ until further notice in writing and debit my/our account accordingly.

Account Number: ____________________________________

Sort Code:_____________________

Account Name: ______________________________________

Signature(s) _________________________________________

Your Address: _______________________________________

___________________________________________________

Date: _________________________

For Office Use Only:

SOS Reference Number: ____________________

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