SCHEDULES
SCHEDULE 1
Form, Delivery, Certification and Registration of Instruments of Disclaimer
1. An instrument of disclaimer under this Act shall be an instrument under seal in the following form or any form to the like effect:
Peerage Act 1963
Whereas I, . . . . . . . . . . . . . . . . . . . . . . . . ., succeeded to the peerage[s] described in the Annex hereto on the date[s] specified in that Annex, and desire to disclaim the said peerage[s] for my life under the above mentioned Act;
And whereas I attained the age of 21 years [before the said date[s]] [on the. . . . . . . . . . . . . . .day of. . . . . . . . . . . . . . . . . . . .];
Now therefore, I, the said. . . . . . . . . . . . . . ., in accordance with the provisions of the said Act, hereby disclaim the said peerage[s] for my life.
In witness whereof I have hereunto set my hand and seal this. . . . . . . . . . . . . . .day of. . . . . . . . . . . . . . . . . . . .
| Signed and sealed by the said . . . . . . . . . . . . . . . . . . . . . . . . . in the presence of: Signature of witness |
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .(L.S.) (Signature) |
Annex
| Description of peerage[s] | Date[s] of succession |
|---|---|
2. Any instrument of disclaimer under this Act shall be delivered to the office of the Clerk of the Crown in Chancery.
3. Where the Lord Chancellor is satisfied that an instrument of disclaimer in respect of a peerage has been delivered within the time allowed by this Act, he shall furnish to the person disclaiming the peerage a certificate to that effect, and shall cause particulars of the instrument and of his certificate to be entered in a register kept by him for the purpose, which shall be open to inspection by the public at all reasonable time.
