Notice of intention to apply for registration of a Lasting Power of Attorney

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. This form can only be used in England and Wales.

LPA 001 04.13

Notice of intention to apply for registration
of a Lasting Power of Attorney

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).

Where attorneys are appointed to act jointly** they all must apply to register.

Details of the person to be told**

Name Address

Telephone no.

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 three 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? the donor the attorney(s)

Which type of LPA is being registered? Property and Health and Welfare
Financial Affairs
(You must complete separate applications for each
LPA you wish to register.)

On what date did the donor sign the LPA? D D M M Y Y Y Y

Details of the donor

Full name Address

Telephone no.

Postcode

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Notice of intention to apply for registration