You must complete one of the following certificates:
Certificate A
I certify that on the day 21 days before the date of the accompanying application, the planning obligation to which
the application relates was enforceable against nobody other than the applicant.
Signed: Date (DD/MM/YYYY):
Certificate B
I certify that the applicant has given notice to everyone else against whom, on the day 21 days before the date of
the accompanying application, the planning obligation to which the application relates was enforceable, as listed
below.
Person on whom notice
was served
Address at which notice was served
Date on which notice
was served
Signed: Date (DD/MM/YYYY):
Certificate C
I certify that:
(a) The applicant cannot issue a Certificate A or B in respect of the accompanying application;
(b) The applicant has given notice to the persons listed below, being persons against whom, on the day 21 days
before the date of the application, the planning obligation to which the application relates was enforceable
Person on whom notice
was served
Address at which notice was served
Date on which notice
was served
(c) The applicant has taken reasonable steps to ascertain the name and address of every person against whom, on the
day 21 days before the date of the application, the planning obligation to which the application relates was
enforceable and who has been given notice of the application but has been unable to do so. These steps were as
follows:
(d) Notice of the application, as attached to this certificate, has been published as follows [newspaper and date]:
Signed: Date (DD/MM/YYYY):
I hereby confirm that I am the person against whom the planning obligation of which
we seek modification/discharge is enforceable, and the information contained in this
application is, to the best of my knowledge, accurate.
Completed application form:
Map identifying the land to
which the obligation relates:
Any other relevant
information: