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Mental Capacity Act 2005
DEPRIVATION OF LIBERTY FORM No. 27
TERMINATION OF A REPRESENTATIVE’S APPOINTMENT
The representative’s appointment expires when the standard authorisation comes to an end. Therefore,
the selection and appointment process must be done afresh if a further standard authorisation is required
because the existing one is coming to an end.
The representative’s appointment may also sometimes terminate before a standard authorisation expires.
Where that happens, the supervisory body must appoint a replacement as soon as is practicable after it is
aware that a vacancy has arisen or will arise.
PART A — BASIC INFORMATION
Name and address of representative previously
appointed for the person
Full name of the person being deprived of
their liberty
Their date of birth (or estimated age if
unknown)
Name and address of the relevant hospital
or care home
Name and address of the supervisory body
Person to contact at the supervisory body
Name
Address
Name
DOB d d m m y y y y
Est. age
Name
Address
Name
Address
Name
Telephone
Email
CASE
NUMBER
GFSB-Liberty Form 27.indd 1 19/2/09 13:28:20
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PART B — TERMINATION OF THE REPRESENTATIVE’S APPOINTMENT
The above representative’s appointment has come to an end.
PART C — NOTICE OF THE TERMINATION
If you have received a copy of this notice, it is because the supervisory body is required to send copies of
the termination of a representative’s appointment to:
(a) the person who is/was the subject of the deprivation of liberty authorisation
(b) the managing authority
(c) any donee of a lasting power of attorney or deputy appointed by the Court of Protection for the person
in (a)
(d) any independent mental capacity advocate instructed under the Mental Capacity Act 2005 and involved
in the relevant person’s case; and
(e) every interested person named by the best interests assessor in their report as somebody they have
consulted in carrying out their assessment.
Signed
(on behalf of the supervisory body)
Dated
Signature
Print name
Position
Date
GFSB-Liberty Form 27.indd 2 19/2/09 13:28:20
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signature
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