Bankers Order Form
	To [your bank]	......................................................................
	Address	......................................................................
		......................................................................
		......................................................................
	Account Name	......................................................................
	Sort Code	_ _  / _ _ / _ _
	Amount to be paid	...................................
	Date of first payment	...................................
	Frequency of payments [eg: monthly / yearly] ..............................
	Please pay to account 40206040 of F.A.I.T.H. Animal Rescue at Barclays Bank, Gt. Yarmouth, Norfolk [20-99-21] the sum of  £ ............... And each succeeding year / month until further notice in writing.
	Signature	......................................................................
	Name	......................................................................
	Address [BLOCK CAPITALS]	......................................................................
		......................................................................
		......................................................................
	Tel	.....................................
	Date	.....................................