Print this form, fill it in and send to your bank.

This instruction supersedes any previous mandate
in favour of The Bagshot Society

STANDING ORDER MANDATE


Paying bank
Enter the name and address of your bank
Paying Account
Account name
Sort code --
number
Payee
Account name The Bagshot Society
sort code 23 - 05 - 80
account number 4 9 8 5 3 3 4 3
Payment details
The sum of Ten pounds (£10)
First payment date immediately
subsequently
the same amount on
1st September 2026
and annually thereafter
until further notice.
Reference SUBS SO
Payee's Authorisation
Name
signature
date