N.3B. When completed this form should be returned in the first instance to: “TH Waik" 54 Park Road, Nottingham, When we have noted the details, we will forward it direct to your bank,
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On receipt of this order and thereafter on the first day of each month, please debit my current account with £ s pie ee aw ce ae POUNOS. . dae ses censs SOtLLings and. siccueneaeepenee) and transfer to the credit of "THE WiEA" (a/c 20 MW 7) at C.W.s.
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Stamp Date Address
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