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BANKERS ORDER
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PLEASE PRINT
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Your name>
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Name (Mr/Mrs/Miss/Ms)
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Your address>
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of
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Postcode
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Please pay to the Robert Stephenson Trust Ltd. the sum of
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annually,
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Date you wish to make first payment>;
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to commence on
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and thereafter on 1st January each year until further notice.
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PAYABLE to: HSBC Bank, Newcastle Branch,
110 Grey Street, NEWCASTLE UPON TYNE,
NE1 6JG (40.34.18) to the credit of The Robert
Stephenson Trust Ltd. a/c 3236052.
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Bank, please quote Ref. No.
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Your Account No.>
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Account No.
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Bank sort code
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Name & Address of your bank>
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To
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Postcode
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Signature
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Date
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PLEASE RETURN ALL FORMS TO THE
TREASURER AND NOT TO YOUR BANK
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