| Paying bank | ||
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Enter the name and address of your bank | ![]() |
| Paying Account | ||
| Account name | ![]() |
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| Sort code | - -![]() |
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| number | ![]() |
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| 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. |
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| Reference | SUBS SO | |
| Payee's Authorisation | ||
| Name | ![]() |
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| signature | ![]() |
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| date | ![]() |
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