LZW LawCall us: 020 7940 4000

Please complete and submit the questionnaire below and a draft of the LPA will be prepared and emailed to you.

If you require a Property and Affairs LPA please ignore the last question concerning consent to life-sustaining treatment.

If you require a Personal Welfare LPA please ensure you answer the the consent to life-sustaining treatment question.

 


Full Name
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Address
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Email address
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Telephone
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Mobile
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Date of birth
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Otherwise/previously known as
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Attorney 1 - Full Name
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Attorney 1 - Date of Birth
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Attorney 1 - Telephone
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Attorney 1 - Mobile
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Attorney 1 - Email
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Attorney 2 - Full name
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Attorney 2 - Date of Birth
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Attorney 2 - Telephone
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Attorney 2 - Mobile
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Attorney 2 - Email
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Additional information
Provide a brief description of any restrictions/conditions/guidance to be added to the LPA
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Notifying others of LPA

Please note that if you do not notify family/friends that you are entering into an LPA then two Certificators will be needed.
Contact 1 - Full Name
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Contact 1 - Telephone
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Contact 1 - Email
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Contact 1 - Address
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Contact 2 - Full Name
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Contact 2 - Telephone
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Contact 2 - Email
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Contact 2 - Address
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Contact 3 - Full Name
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Contact 3 - Telephone
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Contact 3 - Email
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Contact 3 - Address
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Contact 4 - Full Name
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Contact 4 - Telephone
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Contact 4 - Email
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Contact 4 - Address
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Contact 5 - Full Name
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Contact 5 - Telephone
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Contact 5 - Email
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Contact 5 - Address
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Certificator Details
Name
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Telephone
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Email
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Address
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Alternatively LZW can act
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If you require a Personal Welfare LPA please select one option


  

 

Landau Zeffertt Weir Solicitors

The Counting House
53 Tooley Street
London, SE1 2QN
T: 020 7940 4000
F: 020 7378 8025
E: mail@anthonygold.co.uk

Landau Zeffertt Weir Solicitors has been acquired by Anthony Gold Solicitors. Anthony Gold is Authorised and Regulated by the Solicitors Regulation Authority. Our firm number is 48050.
Please use this link to see our terms of business and other policies and procedures.