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HousingServices

City OfficesColebrook StreetWinchesterHampshireSO23 9LJ

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01962 84 84 0001962 84 13 65

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website www.winchester.gov.ukFacebook www.facebook/WinchesterTenants

STANDING ORDER REQUEST FORM

Thank You for choosing to pay your rent by Standing Order.

Please complete the date you wish payments to be debited from your bank account and the frequency.

When completed please send to your Bank or Building Society at your earliest opportunity.

To (Name of Bank/Building Society…………………………………………………(Branch/Office)………………………………………………Sort Code…………….Please pay £ on the (add date)and subsequently pay £ per weekly/fortnightly/monthly

(delete as appropriate)

CREDIT NATIONAL WESTMINSTER BANK LIMITED HEAD OFFICE SORT CODE 62.23.59COLLECTION ACCOUNT NO: 00000000 WINCHESTER CITY COUINCIL

Quoting reference number…………………….(your rent account number)

My/our Bank Account number is ………………………………………………...

Name:…………………………………………………………………………………..

Address: ……………………………………………………………………………....…………………………………………………………………………………………...…………………………………………………………………………………………….

This Order Cancels any instructions already held under the same reference.

Signature…………………………………………………. Date…………….Signature………………………………………………….

Richard Botham Head of Landlord Services