Sheffield Credit Union

Standing Order mandate

This form is used to set up or change a monthly standing order

Please complete and return to : 6 The Gallery, Castle Market, Sheffield S1 2AJ

Your bank / building society details

To the Manager ____________________ (Bank / Building Society)

Address: _________________________

_________________________________

_________________________________

Please initiate the following standing order. This replaces any existing standing order to the Sheffield Credit Union.

Pay to:

The Co-operative Bank, 6 Olympic Court, Salford, M5 2QP.

Sort code: 08-92-50

Account No. 67006568, Sheffield Credit Union

Reference (Membership Number and Surname): ________________________________

The sum of £_________ on the ____ day of each month, beginning on : ________,

until further notice / last payment on ________ (delete as appropriate)

From my account Number _______________ Sort code: ____:____:____

Name: _____________________________

Signature: ________________________ Date __________