Eelam Destitutes

STANDING ORDER PAYMENT TO THE ACCOUNT OF
SIVAYOGAM – EELAM DESTITUTES
(Charity No.1050398)

The Manager

……………………………

……………………………

……………………………

Dear Sir

My Current Account No. …………………………….Please debit my above quoted account and credit the under mentioned account a sum of
Pounds TWENTYFIVE (£ 25.00) only on the ……………. Day of each month commencing from ……………… 2011 until further notice.

Account No. : 8 0 6 0 3 3 0 9
Account Title : SIVAYOGAM – EELAM DESTITUTES
Name of Bank : Barclays Bank, Clapham Group
Sort Code : 20 21 78
Address : P O Box 4038
London SW12 9YB

Please quote reference to my number …………….. each time a ayment is made.

Thank you.

Yours faithfully

My Signature: …………………………………….. and date ……………………….

My Name and Address: Mr. / Mrs ………………………………………………….

………………..……………………………………………….

…………………………………………………………………

……………………..……………Post Code …………………

Telephone No. ………………………. Mobile No ………………………..