Kent Branch : Bankers Order

PLEASE COMPLETE IN BLOCK CAPITALS

To:

Name of Bank:

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

Address of Bank:

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

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

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

Postcode of Bank:

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

Sort Code:

...... - ...... - ......    Account No: ...................................

Please pay to The Jane Austen Society (Kent Branch) at Lloyd's TSB,
Sort Code 30-90-28, Account No. 2002974, the sum of £............ annually
until further notice. This cancels any existing orders in favour of the Society.

Name:

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

Address:

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

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

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

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

Postcode:

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

Signature:

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

Date:

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