To Bank:

Deeds Department

Re Borrowers:

Property:

Mortgage ref:

Dear Sirs

We/I the above-named borrower(s) hereby authorise D’Arcy & Co solicitors of Claregate Street, Kildare Town, Co Kildare to take up on accountable Trust Receipt the title deeds to our property at the above-mentioned address from the above-mentioned lending institution.

Signed:

Dated: