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To the Manager
Bank Ltd.
Address
Post Code...................................
Please pay to the account of the Shropshire Historic Churches Trust (Acc No. 1409408) At Lloyds TSB, 1 Pride Hill, Shrewsbury SY1 1DG (sort code 30-97-62).
The sum of £
.(in words)
..............
On the............day of
......................20
.and annually thereafter.
Your details.
Title............. Full Name (capitals please).......................................................................
Address...........................................................................................................................
.......................................................................................Post Code.................................
Account Name...................................................................
Account Number...........................................................Sort Code........................................ .
Signature
Date
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