To the Donor: Please print off and return the completed form to:
       The Treasurer, SD(Britain), 126 Doversgreen Road, Reigate, Surrey, RH2 8DW

Bankers Order
Details of your Bank Account

Your Bank Name…………………………………………………….

Full Address of your bank…………………………………………………….

                           ……………………………………………………..

                           ……………………………………………………..

                                                                 Postcode………………….
          Sort Code: ……………………..

Account Number: ……………………………………….

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

Please pay to: CAFBANK Ltd
                         PO Box 289
                         West Malling
                         Kent M19 4TA

                         40-52-40

Account Name: Susila Dharma (Britain) (Charity Reg.291818)

Account number:00006143

      Starting on:             /         /                              (give start date)

      The sum of: £                        and the same sum on the same day

                each:             month           quarter            year        (tick one box)

                until: Further notice (or delete and give end date)             /        /

   Signature of
   Account
Holder/Donor:  __________________________________________
___________________________________________________

Remitting Bank
If this order is received late please ensure that all missed payments are brought
up to date at the time this payment is actually made.
Please quote this reference when making each payment.     
                                                                                                     For Office Use Only