SCHEDULE 5 Form of Notice Prospectively Nominating Dominant Tenement

Superior:
(see note for completion 1)

Description of land which is to be the servient tenement:
(see note for completion 2)

Description of land nominated as dominant tenement:
(see note for completion 2)

Specification of condition met:
(see note for completion 3)

Terms of real burden:
(see note for completion 4)

Any counter-obligation:
(see note for completion 4)

Title to the superiority:
(see note for completion 5)

Title to land nominated as dominant tenement:
(see note for completion 5)

Service:
(see note for completion 6)

I swear [or affirm] that the information contained in the notice is, to the best of my knowledge and belief, true.

Signature of superior:
(see note for completion 7)

Signature of notary public:

Date: .”.

Explanatory Note

(This explanation has no legal effect)

This notice is sent by your feudal superior, who is also a neighbour. In this notice your property (or some part of it) is referred to (prospectively) as the “servient tenement” and neighbouring property belonging to the superior is referred to (again prospectively)