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Name of tenant (required)
Trading name (if applicable):
As allowed under clause (required):
In the lease dated (required):
Name of Landlord (required):
Relating to (address of premises) (required):
And to change locks, display necessary termination notices as required; and for so doing this shall be your sufficient warrant, authority and indemnification against all actions at law, as well as costs, charges or expenses which may be reasonably incurred by reason of executing this warrant; and we hereby undertake not to hold you accountable for goods forcibly or clandestinely removed from the premises following their being made secure. Made secure shall be defined by the fitting of new locks and/or any other form of security measure as is seen fit at the time of our officers attendance. We cannot be held responsible should a tenant make forced entry by damaging said locks, doors or any other entrances to the premises.
Type of premises (required):
Normal hours of business (required):
Name of authority (required):
Please leave this field empty.
Name (required):
Telephone (required):
Details of where new keys are to be sent, local agent etc (required):
Dated this (required):
Address (required):
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