Prescribed form of simple declaration from the tenant, declaring that it has received and read the warning notice of exclusion of the provisions of sections 24 to 28 of the Landlord and Tenant Act 1954 from the lease.

NOTE: The form of this declaration is set out in paragraph 7 of Schedule 2 to the Regulatory Reform (Business Tenancies) (England and Wales) Order 2003 (SI 2003/3096). The prescribed form does not include space for the declarant to sign the form, but this may be added after the declaration.

For more information on the procedure to exclude security of tenure from a business lease, see Practice note, LTA 1954: procedure for contracting out.