Bank Details Form

PLEASE WRITE IN CAPITALS AND USE INK

Your Name:

Date of Birth:

Bank Name:

Account Name:

Sort Code (must be 6 digits):

Account Number (must be 8 digits):

Building Society Ref (if applicable):

Signed: _________________________________ Dated: _______________

Please return ASAP

D&R Business Solutions – Payroll Department

1 Vale Parc

Colomendy Industrial Estate

Denbigh

Denbighshire

LL16 5TA

Tel: 01745 813300

Fax: 01745 774922

Please note: late forms may delay payment due