Standing Order Form (Please Click PRINT and complete with ball point pen)

 

Please complete the form below and return it to the address at the bottom of the page.

Once we have received the completed form and it as passed the verification process

we will then forward it to your bank so that they can process payments.

 

1. Name (Mr/Mrs/Miss/Ms)  

Address  
 
 
Post Code
 

Business Name  

I would like to pay Lloyds TSB Rochdale (30-97-11) Branch, 17 Yorkshire   

Street, Rochdale . Lancashire , OL16 1BN for the credit of

B VISIBLE CO UK (Account NO, 01076350)

The sum of: £3.96 each month until I give you further notice in writing.

2. Starting on  

(When completing this section please  
write the date one month from today, 

this will enable you to get maximum value)

   

3. Please insert your bank details                
Account Number                
Bank Sort Code    
-
    
-
    

To Manager (Bank name and address)  
 
 
Post Code
 


4.Signature(s):_______________________________Date:__________________

Please send this form to -

B-visible.co.uk PO BOX 519 ROCHDALE    OL16 9BW

 

The Administrator will send the Standing Order to your Bank.

 

Your Web Page Cannot Be Designed Until This Form Is Received.