Wellcat.org.uk

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To the Manager:

Bank:

Address:

Postcode:

Account Number:

Date:

Please pay National Westminster Bank Plc, 2 Hagley Road, Halesowen, West Midlands, B63 4RQ, sorting code number: 60-09-39 for the credit of Wellcat account number - 85254606 the sum £………and thereafter on the same day monthly / quarterly / annually* until you receive further notice from me / us* in writing.

*Delete as applicable.

Commencing (date of first payment):

Please note: This instruction cancels any previous order in favour of the above named beneficiary.

Name:

Address:

Postcode:

Signature/s: