Headway Rotherham Standing Order Mandate

To (Name of your bank, e.g. Nat West Bank)

Of (Branch Name and Address)

Banch Sort Code:

Your Account Number:

Please credit Headway Rotherham

Account Number: 30428647

Of Barclays, Branch Sort Code 20-76-92, Rotherham Branch
Sheffield & Rotherham Group, PO Box 43, Sheffield, S1 1NG

Amount:

£
each month / year
On the (e.g. 28th December)
each month / year