Lease extension request application
form (subject to contract)
Property address (please include postcode)
Address
Postcode
Tel
Full name of leaseholder(s)
Name(s)
Property details
We wish to extend our lease term of the above property. We confirm the following details:
Property description
i.e. two bedroom flat
Date originally
purchased
Remaining years
on the lease
Which scheme
Leasehold Outright
Leasehold Scheme
Shared Ownership
Shared Ownership/
did you
Owner
for the Elderly
for the Elderly
NBHBY
purchase
(LOS)
(LSE)
(SHOE)
(SO/NBHBY)
under?
Signed 1
Leaseholder:
Print Name:
st
Signed 2
Leaseholder:
Print Name:
nd
Date: