Abdullah Quilliam Society
8-10 Brougham Terrace, Liverpool, L6 1AE
Tel: 0151 260 3986
Email: [email protected]
Web: www.abdullahquilliam.org
Charity Reg No. 1086228
STANDING ORDER MANDATE
To The Manager: (Your bank name) ______________________________________________
Please Pay: HSBC Bank, 99-101 Lord Street, Liverpool, Merseyside, L2 6PG
Account Name: Abdullah Quilliam Society
Sort Code: 40-29-28
Account Number: 01158945
The sum of ______________________(figures)________________________________________(words).
(Insert the amount of each monthly payment in both figures and words)
Commencing on (date____________________) and continuing monthly until (date_______________) or until further notice.
Your Bank Name: ________________________________________________________________
Bank Address: ___________________________________________________________________
Bank Post Code: ___________________
Name of Your Account to be debited: ______________________________________________
Account Number: _______________________________________________________________
Sort Code: _____________________________
Your Full Address & Postcode:
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
Your signature (s) ______________________________________ Date: ______________________
Gift Aid: I want Abdullah Quilliam Society to treat all donations that I make from the date of this declaration until I notify you otherwise as GiftAid donations including all donations I have made for this year and the four tax years prior to the year of this declaration.
Please Tick
Date: __________________
OUR SUPPORTERS