STANDING ORDER AUTHORITY
 
To the Manager______________________________________Bank
 
Branch Address__________________________________________
 
________________________________________________________
 
________________________________________________________
 
Branch Sort Code:
 
 
Account Number: ____  ____  ____  ____  ____  ____  ____  ____
 
Name of Account Holder:__________________________________
 
I wish to pay the sum of 10 (Ten Pounds) to the
LloydsTSB Retirement Club, Birmingham (LTSBRCB)
on January 1st 2020 and Annually until further notice.
Payments to be made to LTSBRCB at:
 
Lloyds Bank (30-16-84)
776 Hagley Road West
Oldbury
B68 0PJ
 
Account Number: 00811450
 
___________________________________________
(Signature)
 
______________________________
(Date)
 
Please return this form to:
David Parkes, 5 Hollywell Road, Knowle, Solihull, B93 9JY