s. 1
— Prescribed form
For the purposes of section 19.2 (1) (c) (iii) of the Patients Property Act, the following is the prescribed form:
Schedule
Undertaking I, .............................................................. [full name of representative], undertake to act in accordance with the representation agreement dated ................................... between ......................................................................... [full name of adult who made the representation agreement] and me. Signed .............................................................. [signature of representative] Date of signature ..............................................