STANDING ORDER MANDATE

From:

                                            (Please type details below and then print form)

Your Full Name:

Your Address:

To The Manager:

Your Bank Name:

Your Bank Address:

Your Bank Account Number:

Your Bank Sort Code:

Standing Order Instruction

Please Pay:

Payee Bank Name:

H.S.B.C. Bank Plc.

Payee Account Name:

Jamiatus Salihat

 

Payee Sort Code:

40-05-07

Payee Account Number:

01330489

Payment Amount:

Frequency:

Date of First Payment:

Reference:

 

Signature:

 

Print Your Full Name:

This form should be completed and forwarded to your own Bank. Alternatively you may post it to our address below and we will send it for you.

      Jamiatus Salihat, P. O. Box 51896, London, NW2 9DY - U.K.