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Princes Street Church Restoration Account
Please fill in your details, using block capitals, and hand this form to the church treasurer or
secretary or by post to: c/o Church Secretary, 25 Belmont Park, Ballinlough, CORK.
Instructions to Bank/Building Society:
Address of your branch
Account Number
.
Branch Sort Code
.
Name of Account Holder
Princes Street Church Restoration Account, A.I.B. Account: 04160-117 sort code: 93-63-83 in the amount of __ __ __ __ on the of every month commencing / /20__
To be discontinued after
. monthly payments.
Signature
.. Date
./
../20__
Contributions exceeding 250 within the tax year, may qualify for tax relief.
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