ADULTS WITH INCAPACITY
(SCOTLAND) ACT 2000
Variation of
Transactions ATF(5)
Notes to complete
Application Form
OFFICE OF THE PUBLIC GUARDIAN (SCOTLAND)
2
Organisations - Fitness to Access Funds
ATF(1) – Request Account information
ATF(2) - Access to Funds
ATF(3) - Additional Joint Withdrawers
ATF(4) - Reserve Withdrawer
ATF(6) - Renewal of Authority
ATF(7) - Transition of Authority
Other application forms
available in this series:
3
Notes to complete this
Form
This form should only be used where an access to funds is already in place and
there is a need to vary the existing transactions or the withdrawer wishes to
apply to carry out other financial transactions not originally identified.
If you require assistance to complete this form please contact the Office of the
Public Guardian (OPG) where staff will be happy to help. Applicants should
refer to the code of practice for access to funds when considering making use
of this scheme.
Section 1 requests details of the existing authority. There is no requirement
to duplicate details of the other interested parties, for example, nearest
relative, primary carer etc. However, where personal details of such
interested parties have changed this should be shown in section
1.2.
If Part A requires to be varied the applicant must identify
the anticipated ongoing expenditure required to meet
the adult’s financial needs and complete the appropriate
section. It is important to consider what standing orders/
direct debits may exist on the adult’s current account. If you
wish such to cease you must identify them in this section
otherwise they will continue to be paid when your new
certificate is produced to the fundholder. Equally you may set
up new arrangements for standing orders/direct debits for the
regular payment of sums from this account. The Public Guardian
reserves the right to request further information or evidence to support
your application.
Where you need to vary the anticipated ongoing expenditure you should
remember to take inflation into account.
Part A of section
2 should only be
completed if you
wish to vary existing
transactions which
have already been
authorised.
4
The examples below show how this can be done.
Example 1: If the adult pays rent, currently payable at £100 monthly and
calculated at £1,200 in year one (£100 x 12 months), you may wish to allow
£1,360 to cover potential increase in year two and possibly £1,580 for year
three. This would total £4,140 over the period of three years. Therefore you
may wish to request £115 per month (£4,140 divided by 36 months) for rent
in your application form. You should apply the same logic in terms of each
heading. If you are not sure the staff at this office will assist.
Example 2: If the adult is in a care home and costs are currently payable at
£250 weekly that would work out at £13,000 in year one (£250 x 52 weeks).
If you estimate that costs might go up by approximately 10%, in year two you
might expect the annual cost to be £14,300 and in year three this figure might
be £15,730. So over the three year period you may require £43,030.
This could be rounded up to £43,200 to cover the full three years,
which divided by 36 (months) would be £1,200 monthly.
It is also possible to apply for a further lump sum where there has been an
unexpected but necessary purchase required which will be of benefit to the
adult. Generally, where requested, the Public Guardian will expect to see
evidence of its purpose in the form of an invoice or similar. An example of the
need for a lump sum is shown below.
Example: The withdrawer finds that remedial work requires to be carried out
on the roof of the adults home. The Public Guardian would expect to
see three written quotes providing a breakdown of the work to
be done together with the withdrawer’s preferred option and
explanation thereof before approving the lump sum in this
instance.
The amounts requested do not need to be exact but it is
important to be sure that there will be sufficient money in
the designated account to ensure the adult is provided for
using his or her funds. Over estimating, within reason, will
not be seen as detrimental to the adult.
The Public
Guardian may request
to see some form of
evidence of anticipated
expenditure, for example,
utility bills, care home
invoices etc as part
of the application
process.
5
Part B allows for other financial transactions which are:
Request to transfer a specific amount of funds from the adult’s current
account to the designated account other than what has been identified in
Section 2.1.1; 2.1.2 and 2.1.3;
• You may transfer a specific amount of funds from the adult’s current
account to the adult’s second account;
• You may transfer a specific amount of funds from the adult’s current
account, provided it is an original account, to any account as specified;
• You may transfer a specific amount of funds from the designated account to
the adult’s second account;
• You may transfer a specific amount of funds from any original account in
the adult’s sole name to the designated account, to the current account, to
the second account or to any other such account as identified;
• Where the second account is a new account you may only transfer funds
therefrom to the designated account;
• You may close any original account; and
• You may terminate an arrangement for payment of funds from any existing
account and if needed re-establish the arrangement on the adult’s current
account or the designated account.
6
This part allows for an existing account to be identified as the adult’s second
account or an account to be opened for that purpose if there is no such
suitable account. A second account must be in the adult’s sole name. If
this account is an existing account it is important to consider what
standing orders/direct debits there are on the account. If you
wish such to continue you must identify them in this section
otherwise they will cease to be paid when access to funds
commences.
It also allows for the termination of any arrangement for
payment of funds from any existing account; the closure of
any original account in the sole name of the adult and the
transfer of specified sums from particular accounts. Section
2.2.2 in this form specifically identifies the parameters.
Section 3 contains an undertaking and declaration which must be
read carefully by the applicant and any other joint withdrawers, who
should all sign and date the application form.
Staff in the Ofce
of the Public Guardian
(OPG) will be happy to
discuss the adult’s
nancial needs with
the withdrawer at
any time.
7
Use the checklist located near the end of the application form to ensure you
have completed all the information requested and then send your application
to the Public Guardian.
A fee is payable for this application and cheques should be made payable to
the “Scottish Court Service”. Details of current fees can be obtained form the
OPG or from our website.
Office of the Public Guardian (Scotland)
Hadrian House
Callendar Business Park
Callendar Road
FALKIRK, FK1 1XR
DX: 550360 Falkirk 3
LP: LP-17 Falkirk
Telephone: 01324 678300
Fax: 01324 678301
Email: opg@scotcourts.gov.uk
Website: www.publicguardian-scotland.gov.uk
The office of the Public Guardian (OPG) is open to the public from
9am to 5pm, Monday to Friday.
This leaflet is available free of charge in Braille, audiotape
large print format, and various non-English languages by phoning
the above telephone number. The OPG subscribes to Language Line
and the RNID Typetalk service.
ATF (5) 1 /9


The information required below can be obtained from your certificate of authority.




In the original application the identity of the adult’s:
•Nearestrelative;
•Primarycarer;
•Namedperson;
•Welfareattorney/guardian;and
•Anyotherinterestedparty
were provided.
There is no requirement to provide this information again, however, if for any reason, their details have
changed and you have not already notified the Public Guardian you should do so below:
You should note that a copy of this application form will be sent to the individuals you
identified in your original application, unless notified otherwise. This is to allow them the
opportunity to make comment, or indeed object, if they wish, to your proposals. This is a
requirement of the legislation.
ADULTSWITHINCAPACITY



ATF (5) 2 /9


(Only complete Part A if you wish to vary existing transactions which have already been authorised)

Since your original certificate was granted, the adult’s circumstances or living costs may have changed.
If that is the case, you should identify below what finances are now required to meet the adult’s ongoing
financial needs.
Before completing this section it is important to refer to the accompanying notes to complete this
application form. This will tell you how to calculate the anticipated expenditure and what supporting
evidence may be required.
ReasonforExpenditureMonthlyAmount£
Gas
Electricity
Telephone (inclusive of mobile phones and special telephone services)
Mortgage
Rent
Insurances (building, contents, motor, personal, pets etc)
Council Tax
TV Licence
Care Charges
Loan Repayments
Club or other subscriptions
Food and household expenses
Clothing
Holidays/Outings
Transport costs
Other (Please specify)

0.00
ATF (5) 3 /9


Detail existing standing orders/direct debits set up on the adult’s current account which you wish to cease
or identify those which you wish to set up on the above account.

The access to funds process not only allows for regular ongoing expenses to be taken but also allows for a
one off lump sum to be requested. A lump sum payment may already have been authorised but in certain
circumstances it may be possible for a further single payment to be made. Before completing this section it
is important to refer to the accompanying notes to this application form. This will tell you what supporting
evidence may be required.
Do you require a lump sum?
If Yes Complete below If No, go to Part B
NameofCompanytowhompayment
iscurrentlymadeforexample,ScottishPoweretc.Amountpayablemonthly£
Cease:
Set Up:
ReasonforExpenditureAmount£
One off payments/lump sums (Please specify)

0.00
ATF (5) 4 /9

If the lump sum requested is to be transferred from the adult’s current account please leave this section
blank, otherwise identify the account from which the lump sum is to be transferred.
You may now apply for authority to carry out more advanced transactions or you can do so at a later date
using this form if required.
Do you wish to apply for authority to carry out other transactions now?
If Yes Complete Part B If No, go to Section 3 – Undertaking and Declaration by Applicant

Branch Name:
Number:
Street:
Locality:
City:
County:
Country:
Post Code:
Sort Code:
Name of Account Holder:
Account Number:
ATF (5) 5 /9

(You should only complete this part if you wish to do more than the basic transactions as identified in
Part A)

In addition to the adult’s current account it is possible to identify an existing account or open another
account in the adult’s sole name which will be known and operated as the adult’s second account. It may
be that there are funds in other accounts which would benefit from being placed into this second account.
Does the adult already have a bank account in his/her sole name which you would wish to operate as a
second account?
If Yes, please provide details below.
If No, do you wish authority to open a second account in the adult’s sole name?
If you wish authority to open a second account in the adult’s sole name please supply information in the
box below.

Branch Name:
Number:
Street:
Locality:
City:
County:
Country:
Post Code:
Sort Code:
Name of Account Holder:
Account Number:

Branch Name:
Number:
Street:
Locality:
City:
County:
Country:
Post Code:
Sort Code:
Name of Account Holder:
Account Number:
ATF (5) 6 /9

Where the adult has several accounts it may be that you need to transfer funds between accounts, close
accounts or terminate direct debits/standing orders etc. There are a number of options available and you
should consider these carefully but note that you cannot do so without approval of the Public Guardian.
The options are:
• Request to transfer a specific amount of funds from the adult’s current account to the designated
account other than what has been identified in Section 2.1.1; 2.1.2 and 2.1.3;
• You may transfer a specific amount of funds from the adult’s current account to the adult’s second
account;
• You may transfer a specific amount of funds from the adult’s current account, provided it is an original
account, to any account as specified;
• You may transfer a specific amount of funds from the designated account to the adult’s second account;
• You may transfer a specific amount of funds from any original account in the adult’s sole name to
the designated account, to the current account, to the second account or to any other such account as
identified;
• Where the second account is a new account you may only transfer funds therefrom to the designated
account;
• You may close any original account; and
• You may terminate an arrangement for payment of funds from any existing account and if needed
re-establish the arrangement on the adult’s current account or the designated account.
You should identify the accounts below and thereafter give specific details of what you want to do with
each as allowed for above:
Please identify any standing orders/direct debits currently existing on the above account which you wish to
retain, terminate or re-establish:
Do you wish to close the above account?
TransferFrom:TransferTo: Amount£
Bank/Building Society:
Sort Code:
Account Holder:
Account Number:
NameofCompany
towhompayment
ismade
Amount
Payable
Retain
YES/NO
Re-establishon
Adult’sCurrent
AccountYES/NO
Re-establishon
Designated
AccountYES/NO
ATF (5) 7 /9
Please identify any standing orders/direct debits currently existing on the above account which you wish to
retain, terminate or re-establish:
Do you wish to close the above account?
Please identify any standing orders/direct debits currently existing on the above account which you wish to
retain, terminate or re-establish:
Do you wish to close the above account?
If there are more accounts identified please use an additional sheet.
All applicants must now complete Section 3
TransferFrom:TransferTo: Amount£
Bank/Building Society:
Sort Code:
Account Holder:
Account Number:
NameofCompany
towhompayment
ismade
Amount
Payable
Retain
YES/NO
Re-establishon
Adult’sCurrent
AccountYES/NO
Re-establishon
Designated
AccountYES/NO
TransferFrom:TransferTo: Amount£
Bank/Building Society:
Sort Code:
Account Holder:
Account Number:
NameofCompany
towhompayment
ismade
Amount
Payable
Retain
YES/NO
Re-establishon
Adult’sCurrent
AccountYES/NO
Re-establishon
Designated
AccountYES/NO
ATF (5) 8 /9



I understand that it is my responsibility to keep records of the exercise of my powers as withdrawer and to
notify the Office of the Public Guardian directly and immediately of any change of circumstances involving
myself or the adult for example, change of address or death of the adult etc.
I undertake to:
a) operate the designated account solely for the purpose of receiving funds transferred under the
authority of any certificate granted and intromitting with those funds; and
b) operate any accounts in the sole name of the adult as directed by my certificate of authority.

I declare that all information contained in this application is true and correct to the best of my knowledge
and I understand that false or misleading information may lead to the rejection of this application or the
termination of any authority already granted.
I confirm that the Office of the Public Guardian is authorised to contact appropriate bodies as it sees fit in
order to seek such information as they consider reasonable in pursuance of this application.

The Office of the Public Guardian will retain and process the information provided herein on computer. This
processing is necessary for the exercise of the statutory functions conferred on the Public Guardian by the
Adults with Incapacity (Scotland) Act 2000. By signing below I understand that I consent to this information
being processed, stored and used by the Office of the Public Guardian in the discharge of its function.
SIGNATUREOFMAIN
WITHDRAWER:
PRINTNAME:
DATE:
SIGNATUREOFOTHER
IDENTIFIEDWITHDRAWER(S):
PRINTNAME(S):
DATE:
Once the application form has been completed you should lodge it with the Office of the
Public Guardian within 14 days of the document being signed and dated.
ATF (5) 9 /9
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