To A.B. (address)
TAKE NOTICE that on .................. (state date of repayment) C.D. (designation), will repay the sum of £ (or the whole amount due) secured by a standard security by the said C.D. (or by E.F.) in your favour (or in favour of G.H.) recorded in the Register for .................. on ........................ Dated this .................. day of ........................
(To be signed by the debtor, or proprietor, or by his agent, who will add his designation and the words Agent of the said C.D.)
In the case of a standard security for a non-monetary obligation this Form shall be adapted accordingly.