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  BANKERS ORDER
  PLEASE PRINT
Your name> Name (Mr/Mrs/Miss/Ms)
 
 
Your address> of
 
 
   
 
 
  Postcode
 
 
  Please pay to the Robert Stephenson Trust Ltd. the sum of 
£
 annually,
Date you wish to make first payment>; to commence on 
 
 
  and thereafter on 1st January each year until further notice.
                                                 
  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.  
  Bank, please quote Ref. No. 
 
 
Your Account No.> Account No.
               
Bank sort code 
           
 
Name & Address of your bank> To
 
 
   
 
 
  Postcode
 
 
  Signature
 
Date 
 
 
 
PLEASE RETURN ALL FORMS TO THE TREASURER AND NOT TO YOUR BANK
 

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