Name

Enter your Full Name (including middle names)

First Name

Last Name

Email Address

Telephone Number

Date of Birth

YYYY

What type of LPA would you like to make (please tick)?

Property & Finance (£650 plus VAT)

Health & Welfare (£650 plus VAT)

Both (£1,100 plus VAT)

Who would you like to appoint as Attorneys (you could have as many as you wish)?

How would you like your Attorneys to act? Please select

Would you like to appoint any replacement Attorney/s? If yes, please enter details below:

Would you like to place on restrictions on how your Attorney/s deal with your Property & Finance and/or Health & Welfare?

If you are making a Lasting Power of Attorney for your Health & Welfare, would you like to give your Attorney authority to give or refuse consent to life-sustaining treatment?

Yes

Who would you like to notify about the registration of the Lasting Power of Attorney?