How to register your lasting power of attorney 0300 456 0300
Transcription
How to register your lasting power of attorney 0300 456 0300
How to register your lasting power of attorney Helpline 0300 456 0300 direct.gov.uk/mentalcapacity LPA110 09.11 © Crown copyright 2011 This guidance published September 2009 to accompany revised 2009 LPA forms. Guidance for people who want to make a lasting power of attorney for property and financial affairs Need help? 0300 456 0300 publicguardian.gov.uk page 1 of xx How to register your lasting power of attorney Guidance for people who want to register a lasting power of attorney Need help? 0300 456 0300 direct.gov.uk/mentalcapacity page 2 of 11 How to register your lasting power of attorney Registering your LPA An LPA can be registered – by the donor or their attorney(s) – at any time after it has been made. But it cannot be used until it has been registered by the OPG. (Where a replacement attorney has replaced the attorney in an unregistered lasting power of attorney, they can also register it.) LPA 001 07.11 LPA002 Notice of intention to apply for registration of a Lasting Power of Attorney 09.11 Office of the Public Guardian This notice must be sent to everyone named by the donor in the Lasting Power of Attorney as a person who should be notified of an application to register. Relatives are not entitled to notice unless named in the Lasting Power of Attorney. Part 1 - The donor Place a cross (x) against one option The application to register may be made by the donor or the attorney(s). Mr. Mrs. Ms. Where attorneys are appointed to act together they all must apply to register. Registering the LPA soon after it is made means that it will be ready to be used by your attorney(s) when needed. The longer the LPA is kept after making it and before registering it, the more likely you or your attorney(s) will need to keep its contents up to date (addresses, contact details, etc.). During this period, your made LPA cannot be amended. If your circumstances change, or your LPA is no longer relevant for some reason, you must complete a fresh LPA form. To register the LPA the person who is making the application: • First: informs each of the people to be told (if there are any) of their intention to register the LPA (by filling-in and sending to each one a copy of form LPA001 – 5 copies are included in your LPA creation pack). This informs them that the LPA is being registered and that they have 5 weeks to raise any concerns. • Then: fills in form LPA002 ‘Application to register a Lasting Power of Attorney’ – also included in your LPA creation pack with separate 4-page guidance notes – and sends this with your completed LPA form to the OPG. Return your completed form to: Office of the Public Guardian PO Box 16185 Birmingham B2 2WH Application to register a Lasting Power of Attorney Miss Other If other, please specify Details of the person to be told Name Last name Address First name Telephone no. Middle name Postcode Address 1 To the person to be told - You have the right to object to the proposed registration of the Lasting Power of Attorney. You have five weeks from the day on which this notice is given to object. Details of how to object and the grounds for doing so are on the back page. Address 2 Address 3 Details of the Lasting Power of Attorney (LPA) Town/City Who is applying to register the LPA? the donor the attorney(s) Which type of LPA is being registered? Property and Financial Affairs Health and Welfare (You must complete separate applications for each LPA you wish to register.) On what date did the donor sign the LPA? County Daytime Tel. no. Postcode D D M M Y Y Y Y If the exact date is unknown please state the year of birth Date of birth Details of the donor Full name D D M M Y Address Y Y Y e-mail address Please do not write below this line - For office use only Telephone no. Postcode LPA002 Application to register a lasting power of attorney (09.11) 1 © Crown Copyright 2011 © Crown copyright 2011 The OPG will check your LPA and application to register form, and contact the applicant if there are any problems. Assuming there are no problems with the LPA and nobody raises concerns, the OPG will register six weeks after sending the notices to the donor or attorney. Guidance for people who want to register a lasting power of attorney Need help? 0300 456 0300 direct.gov.uk/mentalcapacity page 3 of 11 How to register your lasting power of attorney Form LPA001: Notice of intention to apply for registration of a Lasting Power of Attorney In summary The applicant fills in one of these forms for each person to be told (if any), and sends them to the address for each person in your LPA. LPA 001 07.11 How to object to the registering of a Lasting Power of Attorney (LPA) Notice of intention to apply for registration of a Lasting Power of Attorney You can ask the Office of the Public Guardian (OPG) to stop the LPA from being registered if one of the factual grounds at (A) below has occurred. You need to tell us by completing Form LPA007 which is available from the OPG and by providing evidence to accompany it. You must send us the completed LPA007 form within five weeks from the date this notice was given. Failure to tell us could result in the LPA being registered. This notice must be sent to everyone named by the donor in the Lasting Power of Attorney as a person who should be notified of an application to register. Relatives are not entitled to notice unless named in the Lasting Power of Attorney. (A) Factual grounds – you can ask the Office of the Public Guardian to stop registration if: • The Donor is bankrupt or interim bankrupt (for property and affairs LPAs only) The application to register may be made by the donor or the attorney(s). • The Attorney is bankrupt or interim bankrupt (for property and affairs LPAs only) Where attorneys are appointed to act together they all must apply to register. • The Attorney is a trust corporation and is wound up or dissolved (for property and affairs LPAs only) • The Donor is dead Details of the person to be told Name • The Attorney is dead Address • That there has been dissolution or annulment of a marriage or civil partnership between the Donor and Attorney (except if the LPA provided that such an event should not affect the instrument) • The Attorney(s) lack the capacity to be an attorney under the LPA • The Attorney(s) have disclaimed their appointment Telephone no. Form LPA007 is available from the OPG on 0300 456 0300 or www.direct.gov.uk/mentalcapacity Postcode The detail Read all 4 pages of this form as it explains how your people to be told should make any objections (the other two pages of the form are shown on the next page). If it is not possible to establish contact with any of the people to be told, you must keep proof of posting slips, or returned-to-sender evidence, to demonstrate that you have made reasonable efforts. To the person to be told - You have the right to object to the proposed registration of the Lasting Power of Attorney. You have five weeks from the day on which this notice is given to object. Details of how to object and the grounds for doing so are on the back page. Details of the Lasting Power of Attorney (LPA) Note: If you are objecting to the appointment of a specific attorney, it will not prevent registration if other attorneys or a substitute attorney have been appointed. Who is applying to register the LPA? the donor the attorney(s) Which type of LPA is being registered? Property and Financial Affairs Health and Welfare (You must complete separate applications for each LPA you wish to register.) On what date did the donor sign the LPA? ‘Details of the person to be told’: fill in here the details of your person to be told. 2007 versions of the LPA form use the term ‘Named people’. Full name (B) Prescribed grounds – you can only object to the Court of Protection against registration of the LPA on the following grounds: • That the power purported to be created by the instrument* is not valid as a LPA. e.g. the person objecting does not believe the donor had capacity to make an LPA. D D M M Y Y Y • That the power created by the instrument no longer exists e.g. the donor revoked it at a time when he/ she had capacity to do so. Y • That fraud or undue pressure was used to induce the donor to make the power. Details of the donor Completion tips You have the right to object to the Court of Protection about the registration of the LPA, but only on the grounds mentioned at (B) below. To do this you must contact the Court and complete the application to object form they will send you. Using that form, you must set out your reasons for objecting. They must receive the objection within five weeks from the date this notice was given. You must also notify the OPG when you object to the Court by using the separate form LPA008 that the Court will send you. Failure to notify the OPG of an objection may result in registration of the LPA. • The attorney proposes to behave in a way that would contravene his authority or would not be in the donor’s best interests. Address Note: * The instrument means the LPA made by the donor. Telephone no. ** Some of the terms used in the 2007 version of the LPA forms are different to those used in this form and in the LPA002. Postcode ‘Together’ means the same as ‘Jointly’. ‘Independently’ means the same as ‘Severally’. Details of the donor = the person who made the lasting power of attorney. © Crown copyright 2011 ! To avoid rejection of your LPA when applying to register … Page 1 The Court will only consider objections made if they are made on the above grounds. To obtain a Court objection form please contact the Court of Protection at Archway Tower, 2 Junction Road, London N19 5SZ or Telephone 0300 456 4600. Page 4 If you are applying to register both types of LPA and have the same people to be told in both, you must send one of these forms for each of your LPAs. The person to be told will receive two forms as your applications are treated separately. Guidance for people who want to register a lasting power of attorney Need help? 0300 456 0300 direct.gov.uk/mentalcapacity page 4 of 11 How to register your lasting power of attorney LPA001: completed examples Example: completed LPA001 LPA 001 07.11 Signature and date Details of the attorney(s) Notice of intention to apply for registration of a Lasting Power of Attorney Name of 1st attorney Address SHEILA DAVIES This notice must be sent to everyone named by the donor in the Lasting Power of Attorney as a person who should be notified of an application to register. Relatives are not entitled to notice unless named in the Lasting Power of Attorney. The application to register may be made by the donor or the attorney(s). Telephone no. 07666 123 321 solely Where attorneys are appointed to act together they all must apply to register. 45 LANDSBROOKE ROAD BATH, AVON B A9 9 2 P P • The Donor is bankrupt or interim bankrupt (for property and affairs LPAs only) • The Attorney is bankrupt or interim bankrupt (for property and affairs LPAs only) • The Attorney is a trust corporation and is wound up or dissolved (for property and affairs LPAs only) jointly in some matters and jointly and severally in others JANE HUGO Telephone no. 07666 123 321 Postcode To the person to be told - You have the right to object to the proposed registration of the Lasting Power of Attorney. You have five weeks from the day on which this notice is given to object. Details of how to object and the grounds for doing so are on the back page. Details of the Lasting Power of Attorney (LPA) Who is applying to register the LPA? Which type of LPA is being registered? (You must complete separate applications for each LPA you wish to register.) On what date did the donor sign the LPA? ALISON LOUISE WILSON Telephone no. 07666 123 123 ANDREW DAVIES Telephone no. 07666 123 333 jointly the attorney(s) D D M M Y Y 07666 123 444 Y jointly L L9 M M Y Y Y • The Attorney is dead Y • That there has been dissolution or annulment of a marriage or civil partnership between the Donor and Attorney (except if the LPA provided that such an event should not affect the instrument) • The Attorney(s) lack the capacity to be an attorney under the LPA • The Attorney(s) have disclaimed their appointment Form LPA007 is available from the OPG on 0300 456 0300 or www.direct.gov.uk/mentalcapacity 8 LL You have the right to object to the Court of Protection about the registration of the LPA, but only on the grounds mentioned at (B) below. To do this you must contact the Court and complete the application to object form they will send you. Using that form, you must set out your reasons for objecting. They must receive the objection within five weeks from the date this notice was given. You must also notify the OPG when you object to the Court by using the separate form LPA008 that the Court will send you. Failure to notify the OPG of an objection may result in registration of the LPA. jointly and severally Note: If you are objecting to the appointment of a specific attorney, it will not prevent registration if other attorneys or a substitute attorney have been appointed. 27 GEORGES MEWS NEWCASTLE, N E1 2 9 Z Z (B) Prescribed grounds – you can only object to the Court of Protection against registration of the LPA on the following grounds: • That the power purported to be created by the instrument* is not valid as a LPA. e.g. the person objecting does not believe the donor had capacity to make an LPA. Postcode • That the power created by the instrument no longer exists e.g. the donor revoked it at a time when he/ she had capacity to do so. jointly in some matters and jointly and severally in others • That fraud or undue pressure was used to induce the donor to make the power. • The attorney proposes to behave in a way that would contravene his authority or would not be in the donor’s best interests. Address 38 LONDON ROAD POST TOWN COUNTY OP 3 2 5 Y P Postcode Name of 4th attorney © Crown copyright 2011 Address Note: * The instrument means the LPA made by the donor. ** Some of the terms used in the 2007 version of the LPA forms are different to those used in this form and in the LPA002. Telephone no. Postcode jointly Page 1 P Postcode D Address PAUL DAVIES Telephone no. Y 19 VICTORIA ROAD WREXHAM, CLWYD • The Donor is dead 27 1 0 20 0 9 D together in some matters and jointly and severally in others Health and Welfare 2 6 1 020 0 9 Address jointly and severally Name of 3rd attorney the donor and Property Financial Affairs Details of the donor Full name Name of 2nd attorney You can ask the Office of the Public Guardian (OPG) to stop the LPA from being registered if one of the factual grounds at (A) below has occurred. You need to tell us by completing Form LPA007 which is available from the OPG and by providing evidence to accompany it. You must send us the completed LPA007 form within five weeks from the date this notice was given. Failure to tell us could result in the LPA being registered. (A) Factual grounds – you can ask the Office of the Public Guardian to stop registration if: Dated 43 CLIFTON TERRACE NEWCASTLE, NE 1 4 1 S W ALISON LOUISE WILSON Postcode Details of the person to be told Address Print name alison wilson Signed jointly and severally** jointly Name How to object to the registering of a Lasting Power of Attorney (LPA) This notice must be signed by all parties applying to register the lasting power of attorney. ‘Together’ means the same as ‘Jointly’. ‘Independently’ means the same as ‘Severally’. The Court will only consider objections made if they are made on the above grounds. To obtain a Court objection form please contact the Court of Protection at Archway Tower, 2 Junction Road, London N19 5SZ or Telephone 0300 456 4600. jointly and severally jointly in some matters and jointly and severally in others Page 2 Guidance for people who want to register a lasting power of attorney Page 3 Page 4 Need help? 0300 456 0300 direct.gov.uk/mentalcapacity page 5 of 11 How to register your lasting power of attorney Form LPA002: Guidance Notes for completing the application form LPA002 In summary Office of the Public Guardian Application to register a Lasting Power of Attorney Guidance Notes for completing the application form LPA002 Please complete the form LPA002 in BLOCK CAPITALS using a BLACK ballpoint pen, ensuring that all relevant sections are completed clearly. This will enable us to process the information quickly and accurately. Return your completed form to: Office of the Public Guardian PO Box 16185 Birmingham B2 2WH Part 1 - The donor Mr. Mrs. Ms. Miss Other • Form LPA002 cannot be used for registration of an Enduring Power of Attorney. • If you are registering more than one LPA you must complete a separate form LPA002 for each LPA you are registering. If other, please specify Last name Part 1 – The donor Part one covers the information we need about the ‘donor’ of the Lasting Power of Attorney (LPA) to register it. The donor is the person who has appointed an attorney/s to manage their property and financial affairs or health and welfare when first setting up the LPA. • Fill in the box that relates to the donor’s title. If the correct title does not appear, please provide the one now used in the boxes provided to the right. To avoid rejection of your LPA when applying to register … • Please Note: The donor’s surname should be inserted in the line where it says, ‘last name’. Remember to send: • Your made LPA form. • Your completed Application form (LPA002). • Your payment or signed application for a fee remission or exemption. • Please Note: The next two lines are for forename/s. Please ensure that only the donor’s first name is inserted where it says, ‘Forename 1’. • Where the donor is living in a hospital or care home, the name of this should be entered where it says ‘Address 1’. • When completing the address lines, please ensure that the town or city appears where requested. Completion tips • Please Note: Include the donor’s postcode in the boxes provided after the address details. The address to send your application to is: Office of the Public Guardian PO Box 16185 Birmingham, B2 2WH Office of the Public Guardian Place a cross (x) against one option To complete this, please: ! 09.11 Please note the following information: The applicant should • read these LPA002 guidance notes which provide all the information required to fill in LPA002 • fill in LPA002 • send the completed LPA002 and made LPA form with your fee to the OPG. LPA002 Application to register a Lasting Power of Attorney • If the donor’s address on the LPA is different from the one that is shown on the application form, provide the original address in Part five of the form under any additional information and say that the address has changed. LPA002 - Guidance notes (09.11) • Complete the boxes requesting the donor’s date of birth, putting the day, month and year of birth. If you don’t know this, you should be able to find it in the LPA, in Part A under the Donor’s name and address. If the date of birth differs from the date stated on the LPA itself, please explain, if you are able, the difference in Part 12 of the form and provide a copy of the donor’s birth certificate as evidence. First name Middle name Address 1 Address 2 Part 2 – The person(s) making the application Address 3 It is very important for the OPG to know who is applying to register the LPA. Part two of the form informs us who is applying to register the LPA. It may be the donor, the attorney(s) or some other person appointed to apply. The application can be made by the donor or the attorney(s). • If you are the donor or representing the donor applying please place an X in the box next to the statement that says – ‘Is the donor applying to register the Lasting Power of Attorney?’. • If you are an attorney or representing an attorney applying please place an X in the box next to the statement that says - ‘Is the attorney applying to register the Lasting Power of Attorney?’. Town/City County Daytime Tel. no. Postcode If the exact date is unknown please state the year of birth Date of birth D D M M Y Y Y Y e-mail address Please do not write below this line - For office use only • If joint attorneys have been appointed they must make the application jointly. • If attorneys have been appointed to act jointly and severally one or more may make the application. © Crown copyright 2011 LPA002 Application to register a lasting power of attorney (09.11) 1 © Crown Copyright 2011 The detail: If the attorney is making the application, the OPG will formally notify the donor. If the donor is making the application the OPG will notify the attorney(s). If one of the joint and several attorneys makes the application, the OPG will inform the donor and the other attorney(s).It is therefore a good idea to discuss the application to register the LPA with the donor or attorney beforehand. For information about how much it costs to register the LPA, see OPG fees guidance. If the original LPA form is missing, it may be possible to accept a copy certified by the donor or by the solicitor who originally prepared it. In general, only the original LPA is acceptable. You are advised to register your LPA as soon as you have completed the LPA form. Guidance for people who want to register a lasting power of attorney Need help? If you need to act on a donor’s behalf before the LPA is registered, you cannot use the unregistered LPA. If you need to make an urgent decision, you can apply to the Court of Protection (a fee is payable for this). 0300 456 0300 direct.gov.uk/mentalcapacity page 6 of 11 How to register your lasting power of attorney LPA002: completed examples Example: completed LPA002 (pages 1–3) LPA002 09.11 Office of the Public Guardian Return your completed form to: Office of the Public Guardian PO Box 16185 Birmingham B2 2WH Application to register a Lasting Power of Attorney Part 4 - Attorney one Note: We need to know who is applying and how the attorney(s) have been appointed, please answer the questions in parts two and three carefully. Place a cross (x) in this box if attorney one is applying to register Place a cross (x) against one option Mrs. Ms. Is the attorney(s) applying to register the Lasting Power of Attorney? Miss Place a cross (x) against one option Place a cross (x) against one option Is the donor applying to register the Lasting Power of Attorney? Part 1 - The donor Mr. Part 2 - The persons making the application Mr. WI L S O N First name ALI SON Middle name LOUI SE Address 1 3 8 The LPA states whether the attorney is to act solely, jointly or jointly and severally Miss Other Last name D AV I E S First name SHEI LA Middle name Place a cross (x) against one option There is only one attorney appointed Company name (if relevant) Address 1 There are attorneys appointed jointly and severally ROAD If other, please specify Part 3 - How have the attorney(s) been appointed? L O N DO N Ms. Yes Other If other, please specify Last name Mrs. Yes 4 5 L A ND S B R O O K E ROAD Address 2 There are attorneys appointed jointly Address 2 Address 3 There are attorneys appointed jointly in some matters and jointly and severally in others Address 3 Town/City P O S T T OWN County COUNTY Postcode Date of birth OP32 5YP Y Y 07 666 Daytime Tel. no. 1903 1 957 D D M M Y e-mail address Note: We need to know which, if any of the attorney(s) are making this application to register the LPA. You can tell us this by putting a cross in the box at the start of each attorney(s) details in Part 4. 123 1 23 Town/City B AT H County AVON Postcode OP 32 5YP Date of birth 12 051 95 9 D D M M Y If the exact date is unknown please state the year of birth Daytime Tel. no. Y AL I S O N @ I S P . C O . U K Y Y 07 666 DX number DX Exchange Y 123 321 Occupation Please do not write below this line - For office use only e-mail address S H E I L A@ I S P . C O . U K Place a cross (x) against one option that best describes your relationship to the donor Civil partner / Spouse Child Solicitor Other If ‘Other’ or ‘Other professional’, please specify LPA002 Application to register a lasting power of attorney (09.11) 1 © Crown Copyright 2011 Guidance for people who want to register a lasting power of attorney 2 Other professional S I S TER 3 Need help? 0300 456 0300 direct.gov.uk/mentalcapacity page 7 of 11 How to register your lasting power of attorney LPA002: completed examples Example: completed LPA002 (continued), pages 4–6 Part 4 - Attorney two Part 4 - Attorney three Part 4 - Attorney four Place a cross (x) in this box if attorney two is applying to register Place a cross (x) in this box if attorney three is applying to register Place a cross (x) in this box if attorney four is applying to register Place a cross (x) against one option Mr. Mrs. Ms. Place a cross (x) against one option Miss Other Mr. Mrs. Place a cross (x) against one option Ms. If other, please specify Miss Other Mr. Last name DAVI ES Last name First name A NDR E W First name P AU L First name Middle name R O B E RT Middle name Middle name Company name Company name Company name (if relevant) (if relevant) VICTORIA R O AD Address 1 GEORG ES M EWS Address 2 Address 3 Address 3 Address 3 County C L WY D Postcode L L9 Date of birth 22 081 9 6 2 8 LL D D M M Y Daytime Tel. no. Y Y 07 666 DX number DX Exchange N E WC A S T L E County TYNE Postcode N E 1 2 9 ZZ Date of birth 1 0 0319 60 D D M M Y 123 3 3 3 Daytime Tel. no. Occupation e-mail address Town/City Y A ND Y Y 07 666 Town/City WE A R County DX number AN D R E W@ I S P . C O . U K Place a cross (x) against one option that best describes your relationship to the donor Civil partner / Spouse Child Solicitor Other If ‘Other’ or ‘Other professional’, please specify DX Exchange D D M M Y 123 33 3 BROTHER I N L AW Guidance for people who want to register a lasting power of attorney Y Y Y Daytime Tel. no. Occupation AN DR E W @ I S P . C O . U K Civil partner / Spouse 4 DX Exchange Date of birth Y e-mail address Place a cross (x) against one option that best describes your relationship to the donor Other professional DX number Postcode Occupation e-mail address Other Address 1 Address 2 WR E X H AM Miss (if relevant) 2 7 Address 2 Town/City Ms. If other, please specify DAVIES 1 9 Mrs. If other, please specify Last name Address 1 If there are additional attorneys, please provide the following details in the ‘Additional information’ section at the end of this form. Child Solicitor Other If ‘Other’ or ‘Other professional’, please specify Place a cross (x) against one option that best describes your relationship to the donor Other professional Civil partner / Spouse F RI END Child Solicitor Other Other professional If ‘Other’ or ‘Other professional’, please specify 5 6 Need help? 0300 456 0300 direct.gov.uk/mentalcapacity page 8 of 11 How to register your lasting power of attorney LPA002: completed examples Example: completed LPA002 (continued), pages 7–9 Part 5 - Notification of people to be told Part 5 - continued The donor or attorney(s) making the application must give notice to the people to be told nominated by the donor in the section of the LPA marked About people to be told when the application to register this lasting power of attorney is made. The date on which the notice was given must be completed (which is the date it was posted or given to the named person). If the donor decided not to notify any people to be told, please place a cross in the box provided. Date notice given D D M M Y Part 5 - continued Y Y Date notice given Y Last name Last name Place a cross (x) against one option First name First name I Address 1 Address 1 Address 2 Address 2 Address 3 Address 3 D D M M Y Y Y Y D D M M Y Y Y Y The donor did not specify any people to be told in the LPA We have given notice to register in the prescribed form (LP001) to the following person(s): Date notice given 27 10 2009 D D M M Y Y Y Y Last name HU GO Town/City Town/City First name J ANE County County Address 1 43 Postcode Postcode CL I FTON TERRACE Address 2 Date notice given D D M M Y Y Y Date notice given Y Address 3 Town/City N E WC A S T L E County TYNE Postcode NE1 41 SW AND WE A R Last name Last name First name First name Address 1 Address 1 Address 2 Address 2 Address 3 Address 3 Town/City Town/City County County Postcode 7 Guidance for people who want to register a lasting power of attorney Postcode 8 9 Need help? 0300 456 0300 direct.gov.uk/mentalcapacity page 9 of 11 How to register your lasting power of attorney LPA002: completed examples Completion tips Where Attorneys have been appointed Jointly it is necessary for all of the attorneys to apply for registration, this is achieved by signing the LPA002 declaration form on page 11 of the application. The application may be delayed if the OPG needs to clarify and a new LPA002 form may be required. Example: completed LPA002 (continued), pages 10–12 Part 6 - Fees Part 8 - Donor declaration Part 9 - continued Guidelines on fee exemption and remission can be obtained from the Office of the Public Guardian. Note: This section should only be completed by the donor if they are applying for the registration of the Lasting Power of Attorney. Signed Have you enclosed a cheque for the registration fee for this application? Yes No Do you wish to apply for remission of the fee? Yes No Do you wish to apply for exemption of the fee? Yes No Do you wish to pay the fee by credit or debit card? Yes No Date alison wilson Date Last name WI L S O N First name ALI S ON Part 7 - Type of power We apply to register the LPA (the original of which accompanies this application) made by the donor under the provisions of the Mental Capacity Act 2005. D D M M Y Y Y Date that the donor signed the Lasting Power of Attorney Y Y Y Y D D M M Y Y Y Y First name Signed I We apply to register the Lasting Power of Attorney (the original of which accompanies this application). I We certify that the above information is correct to the best of my knowledge and belief. Last name I We have completed the application within the provisions of the Mental Capacity Act 2005 and all statutory instruments made under it. First name Date Part 10 - Declaration by a trust corporation If you are a trust corporation making this application please complete this declaration. Date D D M M Y 26 10 2009 D D M M Y Y Date Last name Signed Health and welfare D D M M Y Y What type of Lasting Power of Attorney are you applying to register? OR Y 27 10 2009 Note: This section should only be completed by the attorney(s) if they are applying for the registration of the Lasting Power of Attorney. Property and financial affairs Y First name Signed Part 9 - Attorney(s) declaration I Y Last name I certify that the above information is correct and that to the best of my knowledge and belief, I have completed the application in accordance with the provisions of the Mental Capacity Act 2005 and all statutory instruments made under it. Signed If you wish to apply for an exemption or remission of all or part of the fee, you must complete the separate application form available from the Office of the Public Guardian. If you wish to pay by credit or debit card, please provide your telephone number so an agent can call you to arrange payment when your application has been received. D D M M Y I apply to register the Lasting Power of Attorney (the original of which accompanies this application). Y Y Y I We certify that the above information is correct and that to the best of my knowledge and belief, I have completed the application in accordance with the provisions of the Mental Capacity Act 2005 and all statutory instruments made under it. Last name Y Company name First name To your knowledge, has the donor made any other Enduring Powers of Attorney or Lasting Power of Attorney? If Yes, please give details below including registration date if applicable Yes No Signed Date D D M M Y Y Y Last name Guidance for people who want to register a lasting power of attorney Signature of authorised person(s) Company seal (If applicable) Last name First name 10 Y First name 11 12 Need help? 0300 456 0300 direct.gov.uk/mentalcapacity page 10 of 11 How to register your lasting power of attorney LPA002: completed examples Example: completed LPA002 (continued), pages 13 & 14 Part 11 - Correspondence address Please write down any additional information to support this application in the space below. If necessary attach additional sheets. Place a cross (x) against one option Mr. Mrs. Ms. Part 11 - Correspondence address Part 12 - Additional information Miss Other Please Note: If this section is left blank, all correspondence will be sent to either the Donor if they are applying or to attorney one listed on the LPA002 If other, please specify Last name First name Middle name Company name Company reference Address 1 Address 2 Address 3 Contact details Town/City Office of the Public Guardian PO Box 16185, Birmingham B2 2WH County DX number Postcode Telephone: 0300 456 0300 (from outside the UK +300 456 0300) DX Exchange Fax: 0870 739 5780 Daytime Tel. no. Email: [email protected] e-mail address Online: direct.gov.uk/mentalcapacity DX: 744240 Birmingham 79 Textphone: 0115 9342778 13 Guidance for people who want to register a lasting power of attorney 14 Need help? 0300 456 0300 direct.gov.uk/mentalcapacity page 11 of 11