COP
1A
07.15
Court of Protection
Annex A: Supporting information
for property and financial affairs
applications
For office use only
Case no. (if known)
Date received
Full name of person to whom the application relates (this is the
name of the person who lacks, or is alleged to lack, capacity)
Please refer to COP1A guidance before completing this form. It is important that this annex form
is fully completed. If you do not have enough information you should consider asking for an
interim order authorising you to obtain information from banks and other financial institutions.
Please note: This annex must be submitted with COP1.
Section 1 - Your details (the applicant) and details of any proposed deputies
1.1 (a) Applicant 1
Proposed deputy?
Yes No
Mr. Mrs. Miss Ms. Other
First name(s)
Last name
(b) Applicant 2
Proposed deputy?
Yes No
Mr. Mrs. Miss Ms. Other
First name(s)
Last name
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If applicable, additional proposed deputies
(c) Proposed deputy
Mr. Mrs. Miss Ms. Other
First name(s)
Last name
(d) Proposed deputy
Mr. Mrs. Miss Ms.
Other
First name(s)
Last name
1.2
Sole deputyship Joint
deputyship Joint and several deputyship
Section 2 - Enduring power of attorney or lasting power of attorney
2.1 Has the person to whom the application relates granted a power of attorney,
enduring power of attorney or lasting power of attorney?
Yes No
Don’t know
If Yes, please state which type(s) the date granted and the date registered
(if known).
Date made Date registered
Enduring power of attorney
Lasting power of attorney property and
financial af
fairs
Lasting power of attorney health and
welfare
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2.2 Please state the name(s) and address(es) of the attorney(s) named in the power
of attorney
Attorney 1
Name
Address
Attorney 2
Name
Address
Attorney 3
Name
Address
2.3 Has the power of attorney been registered?
Yes No
Don’t know
If Yes, please explain why the appointment of a deputy is sought
If No, please explain why an application to register the power of attorney has
not been made
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Section 3 - Will
3.1
Yes No
Not known
3.2
Has the person to whom the application relates made a will?
If Yes, please attach a copy if possible.
If you cannot obtain a copy of the will but you know who holds a copy
, please
give their name and contact details.
3.3
Do you seek authority to obtain a copy of the will?
Yes No
3.4 If known, please provide the names of the executor(s) of the will
Section 4 - Income and assets
4.1
What is the national insurance number of the person to whom
the application relates?
letters numbers
let te r
4.2
Is the person to whom the application relates entitled to any benefits?
Yes No
If Yes, are the benefits received by the person to whom the application relates?
Yes No
If No, please give details of who receives the benefits:
4.3 Please give details below of all income including social security benefits that the
person to whom the application relates is entitled.
Income Annual amount
Earnings £
Occupational pension £
Other pensions £
Annuities £
Other income £
Trust £
Interest £
Investment income £
£
£
Total £
Social security benefits Annual amount
State retirement pension £
Pension credit £
Attendance allowance £
Severe disablement allowance £
Disability living allowance £
Incapacity benefit £
Income support £
Council tax benefit £
Child benefit £
Other benefits £
Total £
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Interest in a deceased’s estate
4.4 Does the person to whom the application relates have any interest in the estate
of someone who has died?
Yes No
If No, go to Section 4.5
Name of deceased
Name of executor/administrator
Approximate value of interest in estate
Is an order required to allow the proposed deputy to obtain a grant in order to
deal with the estate of the deceased?
Yes No
Damages and criminal injuries compensation
4.5 Has a claim been made for an award for damages or, for compensation from
the Criminal Injuries Compensation Authority or is such a claim likely to be
made?
Yes No
If No, go to Section 4.8
If Yes, please give details, including the name and address of solicitors involved,
the present position regarding the litigation, the likely value of the claim and
details of any interim payments that have been, or are going to be, made.
4.6 If a final award has been made please provide details
Copy of nal
order enclosed
4.7 If the award is in excess of £500,000 please annex a brief statement providing
the following details:
(1) Any proposed major capital expenditure (e.g. property)
(2) A budget setting out annual income and the projected
annual costs of care
(3) Investment proposal in outline if known
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4.8 Does the person to whom the application relates have any money held in
bank or building society accounts (or similar)?
Yes No
If No, go to Section 4.9
(You must include any money held at the Court Funds Office)
Bank/Building Society
(or similar accounts)
Account
Number
Type of
account
Names on the account Balance
Total
Continue on separate sheet if necessary
4.9 Does any other person or organisation (other than those already mentioned)
hold money for, or owe money to, the person to whom the application relates?
Yes No
If Yes, please give full details including the name and address of those involved
the amount held and the reason for holding the money, or the amount owed
and reason for loan.
Investments
4.10
Does the person to whom the application relates own any investments such as
stocks and shares, unit trusts, bonds etc?
Yes No
If Yes, please provide an approximate value of the investments held and the
name of the fund manager (if applicable)
Total
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Land and property
4.11 Does the person to whom the application relates own any land or property?
Yes No
If Yes, please enter details below
Property 1 - address
If No, go to Section 4.13
Market value
Balance of any outstanding
mortgage or other legal charge
(e.g. equity release)
If the property is not owned solely by the person to whom the application
relates please provide the following information:
How is the property held?
Joint tenants
Tenants in
common
Name and address of the co-owner(s):
1 Name
Address
2 Name
Address
3 Name
Address
What is the percentage share to which the person to whom the application
relates is entitled?
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%
Property 2 - address
Market value
Balance of any outstanding
mortgage or other legal charge
(e.g. equity release)
If the property is not owned solely by the person to whom the application
relates please provide the following information:
How is the property held?
Joint tenants
Tenants in
common
Name and address of the co-owner(s):
1 Name
Address
2 Name
Address
3 Name
Address
What is the percentage share to which the person to whom the application
relates is entitled?
%
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If more than 2 properties, please continue on a separate sheet
4.12 Is authority sought to sell the property (properties)?
Yes No
If Yes and there is more than one property, please specify which
property is to be sold
1 2 3
If No, please set out proposals for dealing with the property (properties) below:
Important
If a property is held in joint names, the deputy, when appointed, will not have
the legal authority to deal with its sale. This also applies when a property is
held as tenants in common and the co-owner is deceased. Please refer to
guidance notes for further information.
Personal possessions
4.13 Please provide details of any possessions with an approximate overall value in
excess of £10,000 (e.g. paintings, antiques, collections)
Total value
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Business
4.14 Does the person to whom the application relates own or have any interest in a
business?
Yes No
If Yes, please provide the following:
a) the name and nature of the business and its legal status, e.g. partnership,
sole trader etc.
b) the approximate value of the business
c) the value of the share owned by the person to whom the application relates
and their role in the business
d) a draft of any directions or order sought in relation to the business
Expenditure
4.15 Please provide details of the annual costs of care (maintenance)
Where the person to whom the application relates lives in a nursing/care
home, are they liable to contribute towards the cost?
Yes No
If Yes, what is the weekly amount?
Debts and money owed
4.16 Does the person to whom the application relates have any outstanding debts
in excess of £1,000?
Yes No
If Yes, please give details of any debts of the person to whom the application
r
elates including the name(s) of any creditors and the amount of the debt.
Creditor Amount
Total
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Section 5 - Visits
Please provide details of who visits the person to whom the application relates and how often.
Section 6 - Other information
Please provide any background or additional information which you think might be relevant, or of
assistance to the court, when making its decision, including consideration of section 4(6) of the Mental
Capacity Act 2005.
Section 7 - Statement of truth
The statement of truth is to be signed by you, your solicitor or your litigation friend.
*(I believe) (The applicant(s) believe(s)) that the facts stated in this annex are true.
Applicant (1)
Signed
*Applicant(’s litigation friend)(’s solicitor)
Name
Date
Name
of firm
Position or
office held
Applicant (2)
Signed
*Applicant(’s litigation friend)(’s solicitor)
Name
Date
Name
of firm
Position or
office held
* Please delete the options in brackets that do not apply.
If there are more than 2 applicants, please continue on a separate sheet.
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Court of Protection
COP1A Notes
Guidance notes on completing form COP1A Annex A: Supporting
information for property and financial affairs applications
Please read the following notes before
completing Annex A
You must complete and file this annex to form COP1 if
your application relates to property and affairs matters.
This includes applications to appoint a deputy for
property and affairs.
If your application relates to another matter then you
may need to complete a different annex. Refer to
Section 1 of form COP1 and the notes to form COP1
for information on what forms to complete.
Completing form Annex A
Please ensure that you provide all relevant information
to support your application. If you do not have
full details of bank/building society accounts and
investments you may need to apply to the court for an
interim order to obtain these details.
Please continue on a separate sheet of paper if you
need more space to answer a question. Write your
name, the name and date of birth of the person to
whom the application relates, and the number of the
question you are answering.
What you need to do next
When you have completed this form, you will need to
consider what other forms and documents you need
to complete. Refer to the guidance notes on form
COP1 for information on what forms to complete and
what you need to do next.
When you have completed all the forms you should
take, or send them to the Court of Protection, along
with any fee. For details on where to send your
application check the website:
www.gov.uk/court-of-protection
Disclaimer
Court of Protection staff cannot give legal advice.
If you need legal advice please contact a solicitor
or your local Citizens Advice Bureau. Information in
this guidance is believed to be correct at the time of
publication; however we do not accept any liability for
any error it may contain.
If you need further help with your application, please
check the website www.gov.uk/court-of-protection
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