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Postal Multiple

Payments

Version 06/2007

SINGLE PAYMENT FOR MULTIPLE APPLICATIONS ON THE FOLLOWING APPLICATION FORMS:


FLR(M), FLR(O), FLR(S), FLR(IGS), FLR (FT:WISS), BUS, SET(F), SET(M), SET(O), SET(DV),
NTLTOC, COA

PAYER’S DETAILS
1 Contact name

2 Contact address

Post code

NUMBER OF APPLICATIONS AND TOTAL AMOUNT TO PAY

3 Total number of applications listed on 4 Total amount to pay


page 2 (minimum 2; maximum 25) £

Please make sure the totals are the same as the those on page 2.

PAYMENT DETAILS - please complete as appropriate


5 Payment method - please tick Postal Cheque Debit or Banker’s
order credit card draft
6 Paying by cheque
Cheque number Account number Sort code

7 Paying by Please debit my: Visa / MasterCard Delta Switch Maestro


card Electron / Solo

8 Name on
card

9 Card
number
Valid from Expiry date Card security number - CVV Issue Nº (where available)
10 Card details

11 Signature (card Date


payments only)

Please list the individual applications and fees on page 2.


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Main applicant’s full name Date of birth Nationality Form used Fee to pay

1
£
2
£
3
£
4
£
5
£
6
£
7
£

8 £

9
£

10 £

11 £

12 £
13
£

14
£

15
£
16
£
17
£
18
£

19 £
20
£

21
£

22 £

23 £

24 £

25 £

Total number of applications Total amount to pay £


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