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Peerage Act 1963

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SCHEDULES

Section 1.

SCHEDULE 1U.K. Form, Delivery, Certification and Registration of Instruments of Disclaimer

1U.K.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 theday 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 thisday of

Signed and sealed by the said in the presence of:
Signature of witness (L.S.) Signature
Address
Description

Annex

Description of peerage[s]Date[s]of succession

2U.K.Any instrument of disclaimer under this Act shall be delivered to the office of the Clerk of the Crown in Chancery.

3U.K.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 times.

4U.K.A certificate of the Lord Chancellor that an instrument of disclaimer was delivered within the time allowed by this Act shall be conclusive evidence of that fact, but shall not be evidence of any other matter relevant to the validity of the instrument, including the right of the person by whom it was delivered to any peerage to which it relates.

F1F1SCHEDULE 2U.K.

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