(Registered Charity No. 1084279)

BANKER'S ORDER FORM

To: (your bank)_______________________________________________________

Address_____________________________________________________________

____________________________________________________________________

Postcode____________________________________________________________

Please pay to the SUFFOLK RECORDS SOCIETY (Account No 00006869) at CafCash Ltd, Kings' Hill, West Malling, Kent (Code 40-52-40) the sum of £12.50 (Twelve pounds and fifty pence) on the 

___________day of__________________________20_____________________

and on the same day in each succeeding year until further notice.

This order cancels any previous order payable to this account number.

Name (in capitals)_____________________________________________________

Address_____________________________________________________________

____________________________________________________________________

____________________________________________________________________

Postcode____________________________________________________________

My account number___________________________________________________

Signed_____________________________________Date_____________________

 

This completed form should be returned direct to the Suffolk Records Society, c/o Kitwood Farmhouse, Kitwood Lane, Ropley, Alresford, Hants SO24 0DB.