To …………………………. Bank

Postal Address …………………….………………………………………………………………………

Please pay CAF Bank Ltd

25 KINGS HILL AVENUE
KINGS HILL
WEST MAILING
KENT
ME19 4JQ

For the credit of HEADWAY CARDIFF

Sorting Code 40.52.40

Account Number 00014189

The sum of £………… Amount in Words ……………………………………………

Name of Account to be debited …………………………………………………….

Sorting Code ………………… Account Number ………………………………

Signature(s) …………………………………

Date ……………….