|To the Manager, Bank/Building Society
(please complete name of Bank/Building Society)
(please complete address of bank/building society, incl postcode)
Please pay: Unity Trust Bank PLC, Nine Brindleyplace, Birmingham B1 2HB
For the credit of: GI Trust ASCO, Sort code: 60-83-01, Account number: 20249456
|The sum of: (in words) ____________________pounds (£ )
Starting on 201___ and thereafter every month until further notice, and debit my account accordingly
|Name of account to be debited:|
|Address of account holder:|
|Bank sort code:|
Signed: _____________________________ Date: _________________
Please call 07866 456 776 if you have any queries.
When completed, please return this form to GI Trust, 53 Stoke Lane, Westbury on Trym, Bristol BS9 3DW. We will then send this form on to your bank. Thank you for your support!