Bank or building society account details form

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1 Bank or building society account details form This form asks for details of the bank or building society account into which you want us to pay your grant. Please complete the form and return it to us. All grant holders must complete and sign Section A. Without this information we will be unable to make grant payments. If your organisation is not a statutory authority, you must also complete Section B and provide details of all the people who can sign cheques or authorise withdrawals from this account in Section C. We will then send the form to your bank or building society and ask them to complete Section D. Please do not send this form direct to your bank or building society. Separate and designated bank or building society accounts (not applicable if you are a registered charity) Please note that we require the following organisations to set up a separate bank account for the sole purpose of receiving and administering Big Lottery Fund grants: company limited by shares or guarantee community interest company (CIC) limited liability partnership partnership mutual society unincorporated association. These organisations should give details of their separate and designated bank or building society account in this form. The separate and designated account must have a minimum of two signatories (who must not be related to each other or live at the same address) for any cheque or withdrawal. It must also bear the legal name of your organisation and state BIG in brackets, for example The Blue Team (BIG). page 1of 5

2 Section A (for completion by all organisations) Unique Reference Number (URN) of this grant (office use only) Organisation s legal name as it appears on your governing document Name and address of bank or building society branch you hold an account with Account name Sort code Account number Building society roll number account was opened How many people are authorised to sign on the account? Give the address (including the postcode) that the bank or building society have on record for this account. If there is any difference between your organisation s legal name and the name as it appears on your bank or building society account, explain why below. You may need to supply documents to support your explanation. If you have any queries about this, please contact us. Declaration (this should only be signed by your organisation s chair, chief executive or person of similar authority) I confirm that the information given on Section A of this form is correct. I will notify the Big Lottery Fund if any of these details change and understand that grant payments may be affected if I do not. I confirm that I am duly authorised to sign this form on behalf of the organisation. Name in full page 2 of 5

3 Section B: for completion by non statutory organisations only Please confirm the number of people who can sign cheques and make withdrawals from this account. Please list below the names of all the authorised signatories. Each authorised signatory must also complete and sign the authorised signatories details form in Section C. Ref Name Are any of the people authorised to sign cheques or withdrawals from the account related to each other or living at the same address? Yes No If any of the authorised signatories are related to each other or living at the same address, enclose written confirmation from your bank or building society that they cannot authorise the same payments Organisation s declaration and permission for bank or building society verification (this should only be signed by the organisation s chair, chief executive or person of similar authority) I confirm that I am authorised to sign this form on behalf of the organisation named in section A and that the information given in Section B is correct. I have attached a completed authorised signatories details form (Section C) for each of the above authorised signatories. I will notify the Big Lottery Fund if any of these details change and understand that grant payments may be affected if I do not. I authorise the bank or building society named in Section A to verify the details given on this form if they are asked to do so by the Big Lottery Fund. I understand that the bank or building society may make a charge to the account shown for doing so and agree to accept that charge. Name in full page 3 of 5

4 Section C: Authorised signatories details form Each person listed in Section B is authorised to sign cheques or make withdrawals from the account and must complete and sign a copy of this authorised signatories details form. Please copy this section as required, inserting the reference number from Section B for each signatory. You should return all the authorised signatories details forms to us with the completed Bank and building society details form. We will send them to your bank or building society for verification. Signatory Reference number from Section B Title Forenames (in full) Surname of birth Phone number address Home address (including postcode) Declaration I authorise the bank or building society named in section A of the Bank and building society details form to verify the above details if they are asked to do so by the Big Lottery Fund. page 4 of 5

5 Section D: For bank or building society use ONLY. Fill in ONE of these bank or building society account confirmations. For banks or building societies that use an official bank stamp To: The Manager, organisation s bank or building society I confirm that the account named in Section A of this form exists, is active and all the details given are correct. I confirm that, in compliance with current regulations, we have verified the identities and details of the authorised signatories attached with this form. Name Official stamp and address for bank or building society Signed Position in bank or building society For banks or building societies that do not use an official bank stamp We do not use an official bank stamp and have attached confirmation of the bank or building society account named in Section A, in a form that is in line with our own internal procedures. Please tick this box and attach your bank or building society account verification page 5 of 5

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