Nomination of Shares on Your Death Form

Nomination of shares on your death form

You can nominate a person to whom you wish your shares to be transferred on your death. If the person you nominate is under 16 years old, you will need to appoint a trustee. Low Carbon Hub will respect your wish in so far as the law and our Rules permit.

Please ensure all parts of this form have been completed in BLOCK CAPITALS

Investment details
Please enter the details to which these changes are applicable, and any certificate(s) you have relevant to that investment.
Certificate Number
Full name and registered contact details of the first named investment holder
The first named investment holder will be dealt with as the principal investment holder. The address and contact details are only required for the principal holder on behalf of all other holders on the certificate.
Title / First Name(s) / Company Name / Last name
Address / Member reference (if applicable)
Telephone number
Postcode
Email
Personal details of your nominee
Title / First Name(s) (in full) / Last name
Address / Member reference (if applicable)
Telephone number
Postcode
Email
Date of birth (if under 16)
Trustee details (if nominee is under 16)
Title / First Name(s) (in full) / Last name
Address / Member reference (if applicable)
Telephone number
Postcode
Email
Signature
I understand that it may not be possible for Low Carbon Hub to action this request and I and my heirs will not hold the Society responsible for its actions. I understand that these instructions can only be revoked or amended by my giving clear written instructions to the Secretary of Low Carbon Hub IPS at its Registered Office. I understand that trustees will need to be appointed if my nominee is under 16 years of age.
Signed as a Deed / Date
Name in Print
Signature of Witness / Date
Name in Print

Please return this form to: Low Carbon Hub, 9 Park End Street, Oxford, OX1 1HH or scan and email to .