Fill - Free fillable Atf 5---variation Of Transactions (Office of the Public Guardian) PDF form

ADULTS WITH INCAPACITY

(SCOTLAND) ACT 2000

Variation of

Transactions ATF(5)

Notes to complete

Application Form

OFFICE OF THE PUBLIC GUARDIAN (SCOTLAND)

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:

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.

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.

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.

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 Ofce

of the Public Guardian

(OPG) will be happy to

discuss the adult’s

nancial needs with

the withdrawer at

any time.

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

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

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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Atf 5---variation Of Transactions (Office of the Public Guardian)

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