Instruction to create a standing order.

Your full name :	__________________________________
Sort code (being debited)	___ - ___ - ___
Account number	__ __ __ __ __ __ __ __
Your contact phone number:	__________________________________
Name of bank:	__________________________________

Please set up a standing order:

Recipient’s name: UK Outdoor Fitness Ltd
Sort code & account number (official use only):
LloydsTsb Bank plc. Leeds Commercial Centre
6/7 Park Row, Leeds. LS1 1NX

Amount: £	_______________
Amount in words:	______________________________
Date of first payment:	___ : ___ : ___
Date of regular payment:	_______________
Frequency of payments	Monthly

Please make the payment until last notice

I authorise you to set up the standing order in accordance with my instruction.

This request is addressed to the Bank which holds my account.

Your signature:	_____________________________________
Date:	_____________________________________

Please hand this form into your instructor

UK Outdoor Fitness Ltd, 2 Clifton Moor Business Village, James Nicholson Link, York YO30 4XG
Tel: 07989586798 enquiries@ukoutdoorfitness.com Registered in England No. 7117131