PLEASE COMPLETE SIGN AND RETURN TO JIM DOW FOR

Standing Order Mandate

Bank/Building Society:

Bank/Building Society Address:

Sort Code:

Account Number:

Account Holder Name(s):

Address:

Prize Draw Number

Please Debit £

Monthly

Annually

On the 15th of each month.

As soon as possible and annually thereafter.

until this instruction is cancelled

Signed:

For Bank Use Only

Please credit payments to:

Bank of Scotland

The Direct Business

PO Box 1000

BX2 1LB

Sort Code;

Account Name; Inverness Bowling Club Prize Draw

Account No;

This order supersedes any current instruction