The Lin Berwick Trust Banker's Order Form

 Registered Charity 1083039 

To: The Manager (please give name and address of your bank or building society)

 ________________________________________________________________________________

________________________________________________________Postcode__________________

Account Number ___________________________Sort Code________________________________

Please pay the sum of £________________to The Lin Berwick Trust *monthly/quarterly/annually until further notice with effect from  _______________________  (please specify date of commencement).

*delete as applicable

Your contact details (please print):

Name ________________________________________________________________­­­­­­­­­­­­­____________

Address___________________________________________________________________________

______________________________________________________Postcode__________________

Signature____________________________________Date________________________