Standing Order Mandate

Please complete and send to your bank

Please pay National Westminster Bank PLC        Sort Code: 60-17-11

153 Putney High Street Branch

For the credit of R.C Archdiocese of Southwark- Putney Parish

Account Number: 20404131

The sum of Amount in words………………………………………………

Amount in Figures…………………………………………………….

Commencing: Date: ……………………………………….

And thereafter every week/month/quarter/year

on (due date)…………………………………………..

until you receive further notice from me/us in writing

quoting the reference………………………..and debiting my/our account accordingly.

Please cancel any previous standing Order in favour of the above beneficiary under this reference

Account to be debited                                            Account Number

……………………………………………………………………………………………………

Signature(s) ……………………………                           Date…………………

……………………………..