WP E-Signature by Approve Me - Sign Documents Using WordPress -

Colts payment mandate 2021-2022

Please use this form to submit your direct debit details to the Club. Your account will be automatically billed the amount specified at the bottom of the form. After successful submission of the form, you will be redirected to pay the league registration fee.

Player's name:

Player's age group:

Team colour:

Payee's name:

Payee's address:

Payee's postcode:

Bank name:

Bank address:

Bank postcode:

Account number:

Sort code:

Please pay from my account to: Haverhill Rovers Ladies and Youth

Bank: Barclays Bank plc, 39 High Street, Haverhill, Suffolk, CB9 8AE

Account number: 23926605

Sort code: 20-74-05

Amount: £45 (forty-five pounds)

Payments to be made quarterly, on the (please select day) of August 2021, October 2021, December 2021 and February 2022

Leave this empty:

Your legal name

Your email address

Please Confirm full name and signature.

Draw Signature
Type In Signature

Draw your signature with your mouse, tablet or smartphone Clear

I agree that I am and I agree this is a legal representation of my signature for all purposes just the same as a pen-and-paper signature

I agree that I am and I understand this is a legal representation of my signature

Timestamp

Audit

20th July 2021 12:27 pm BST

Colts payment mandate 2021-2022 Uploaded by Peter Betts - hrfcadmin@thenewcroft.co.uk IP 185.24.122.181