BANKERS ORDER FORM

 

Please complete the form below.

 

To (insert the name of your bank)

 

 

of (bank branch address)

 

 

 

 

Postcode

 

 

My account no.

 

Sort Code

 

 

Please pay to: Barclays Bank plc, Highfields, Leicester, LE2 1HJ

 

For the account of: The Ulverscroft Foundation

 

Account No.

70753815

Sort Code

20-49-11

 

The sum of

(pounds)

 

on the

 

 

and the same sum on the same day each month / each year (please delete)

 

Signed

 

 

Date

 

 

PLEASE RETURN THIS COMPLETED BANKERS ORDER FORM WITH THE GIFT AID DECLARATION (IF APPROPRIATE) TO THE ADDRESS BELOW

 

Ulverscroft Foundation, The Green, Bradgate Road, Anstey, Leicestershire. LE7 7FU

 

Thank you for your support