To the Manager ………………………………………………………………
Bank plc
Address of Bank:
Postcode:
Please pay to Lloyds TSB Bank plc, sort code 77-25-13 NOW* and on
the 1st
of November each year until further notice the sum of:
£……………….
For the credit of The Portchester Society account, number
00226863
* delete "NOW* and" if dated between 1
September and 31 October
This cancels any existing order to The Portchester Society
Signed: ……………………………………………………………
Date ………………………….….
Full Name (Block
Letters): ……………………………………………………………………………
Address:
…………………………………………………………………………………………………
…………………………………………………………………
Post Code: ……………………………