TAXI

16 TAXI |22 SEPTEMBER 2015 www.ltda.co.uk | @TheLTDA
[FIRST TWO MONTHS FREE FOR NEW MEMBERS]
✃
APPLICATION FORM
JOIN FOR £16.80 PER MONTH WITH
£12.80 ALLOWABLE AGAINST TAX!
Name
Address
Tel
Email
Date of Birth
Mobile
Postcode
Badge No. Green (G) or Yellow (Y) When obtained - Month Year
Have you been a member of the LTDA before? (Please tick) YES NO
Please tick if you DO NOT wish to receive information from the LTDA and other related organisations
in the future
I understand that my application for membership of the Association must be approved by the Council of
Management and that a Share Certificate will be issued to me if my application is confirmed.
Signed
Please complete parts 1 to 5 below to instruct your branch to make direct payments from your account.
Then return the form to the LTDA, FREEPOST, (PAM 2005), London W9 2BR
LTDA Basic Direct
Debit Instructions
INSTRUCTIONS TO YOUR BANK/BUILDING
SOCIETY TO PAY DIRECT DEBITS:
To the manager of
Address
1. Please write the name and full postal address of your
branch in the spaces above.
2. Name of account holder
3. Account number
4. Bank sort code
Date
5. Your instructions to the Bank/ Building
Society, and signature:
• I instruct you to pay direct debits from my account
at the request of the LTDA LTD.
• The amounts are variable and may be debited
on various dates.
• I understand that the LTDA LTD may change
amounts and dates only after giving me prior notice.
• I understand that if any Direct Debit is paid which
breaks the terms of this instruction, the Bank/
Building Society will make a refund.
Signature(s)
Date
For Office use only
Originator’s Identification No.
9 1 4 4 2 8
Originator’s Reference
CALLING ALL CABBIES
Bank/Building Societies may not accept instructions to pay Direct Debit from some types of account
Phone 0207 286 1046 now!
[ CAN
LTDA
YOU AFFORD NOT TO JOIN? ]