Standing Order Mandate




		Veterinary Clinic

67 Station Road
Woburn Sands
Milton Keynes MK17 8SH

01908 282101


	Standing Order Mandate

To: The Manager

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............................................................. (Your Banks Address)

.............................................................

..............................................................


	Please pay: The Royal Bank of Scotland 402 Lower Twelfth Street Central Milton Keynes MK9 3LF

For the credit of: Greensands Veterinary Clinic
   Account Number 10204267
   Sort Code 16-25-27

The sum of: £……………………

Commencing on ………………….. and thereafter every 15th day of the month until further notice and debit my account accordingly:-

Account to be debited: ………………………………….

Account number: …………………………………. (Your Account Details)
Sort code: ………………………………….

   Signature: ____________________________________

   Date: ________________________________________

   This Standing Order Mandate supersedes all previous standing orders to Greensands Veterinary Clinic