Name: ………………………………………

Please draw from my bank account on 28th of every month as a donation to Mandir.

Amount: SKr. 101, 201, 501

(or any amount, please write below)

SKr: …………….

Bank name: ………………………………………………….

From account no: …………………………………………

My address: ……………………………………………………………

Phone home: …………………………………

Name of family members: ………………………………………..

Kindly return this form personally in Mandir or send by post to Åkervägen 1, 19140 Sollentuna

or

FAX to 08-53020862

For more information please call to Mr. Pradeep Rastogi 08-53020862 (Home)