EXCHANGE OF BANK OF ENGLAND NOTES (BUSINESS VIA POST)
DECLARATION (to be completed by applicant) Date _______________________________
Completed forms should be sent (with a company headed letter) to:-
Dept NEX, Bank of England, Threadneedle Street, London, EC2R 8AH.
Please exchange the following note(s):-
Quantity Series Value
@£50 = £
@£20 = £
@£10 = £
@£5 = £
@£1 = £
@10/- = £
Total Value
= £
Brief description of where the banknote(s) are from, where found or reason for exchange (as appropriate):
______________________________________________________________________________________________
COMPANY NAME
REGISTERED NUMBER
REGISTERED OFFICE in
country of incorporation
BUISNESS ADDRESS
TELEPHONE NUMBER
EMAIL ADDRESS
Business point of contact
Name (Block Capitals): ______________________________________________________
Signature: ______________________________________________________
Email address (if different to above): ______________________________________________________
DATA PROTECTION ACT 1998 - FAIR COLLECTION NOTICE (please read before signing):-
The Bank of England will process your information in accordance with current data protection legislation. The Bank of England may process your
information for the purpose of the Bank’s business and associated activities, and may disclose your information to external third parties. Your
information will not be processed for direct marketing purposes. You have the right to ask for a copy of information held about you in our records, for
which you may be charged a small fee, and to require us to correct any inaccuracies, by writing to the Data Protection Officer, Bank of England,
Threadneedle Street, London EC2R 8AH.
Payment Details
Bank: __________________________________ Account Title:_________________________________________
Sort Code Account Number