DEP2
Information for Court of Protection Team – Deputyship Application
As the basis for the application please complete this form with as much information
as possible/or that you are able to find out.
Full Name (Including Title)
Details of Respondents
This should be any person(s) who you reasonably believe has a significant interest in the Service Users
affairs, which means they ought/want to be heard by the court in relation to the hearing
Full name including title
Full address including postcode,
telephone number & e-mail address
Connection to the Service User
Other People who will need to be notified
You should try to identify at least 3 people to be notified in the application that have not been named above
Please turn over for guidance notes
Full name including title
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Full address including postcode,
telephone number & e-mail address
Connection to the Service User



a)
b)
c)
d)
e)
f)
g)
h)
i)
j)
If close family member have not been named above they should be listed in descending order as shown
below. You do not need to provide details of close family members who have had little or no involvement with
the Service User or If there is another good reason why they should not be notified
In some cases, the Service User may be closer to people who are not relatives and if so please provide their
details
If you decide to list family in any categories shown below then all family falling in that category should be
listed unless there are good reasons why they should not be notified
Spouse or civil partner
Person who is not a spouse or civil partner but who has been living with the person to whom the application
relates as if they were
Parent or guardian
Child
Brother or sister
Grandparent or grandchild
Aunt or uncle
Niece or nephew
Step-parent
Half-brother or half sister
Are you aware of any previous application(S)
to the Court of Protection for the Service User
If Yes Please Supply the following details
*Yes / No
The name of the applicant
The date of the order
Case number
Copy of court order attached
* Delete as applicable
*Yes / No
What type of accommodation is the Service User living in
 Own Home

 Family member/friend’s home (including spouse/civil partner)

 Private rented home

 Council rented home

 Housing Association rented home

 Supported housing e.g. provided by organisation such as YMCA

 Local Authority nursing home or residential home

 Private nursing home or residential home

 NHS accommodation e.g. hospital, hostel

 Private hospital

 Other (please give details below)

When did Service User move to Current address? (if Known)
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If Service User lives in private accommodation do they share it with
anyone else
*Yes / No
* Delete as applicable
If Yes, please give the name of the other person(s) and state their connection to the person
to whom the application relates
Marital Status
 Married or in a civil partnership
 In a relationship with a person who is not a spouse or civil partner, but living
together as if they were
 Separated

 Divorced or their civil partnership has dissolved



……………………………………………
Date of divorce/dissolution

 Widowed or a surviving civil partner
Date of death or spouse/civil partner
……………………………………………

 Single
Do you personally visit the Service User
*Yes / No
If Yes how frequently
Does anyone else visit the Service User
* Delete as applicable
*Yes / No
If Yes please provide details of the most frequent visitors
Please include Name, connection to Service User and frequency of visits
Name
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Connection to the Service User
Frequency of visits
If Service User lives in his/her own home, please give brief details of the arrangements made
for domestic assistance and care and details of any proposed changes, e.g. meals on
wheels, homecare or any disability equipment they have.
Please provide name, address and telephone number for any GP or practitioner of the
Service User
Is there a Guardianship Order on the Service User
* Delete as applicable
*Yes / No
If Yes please give below the full name, address and telephone number of the guardian or
name of the Local Authority
Has the Service User made a Will
If Yes do you know who holds the will
* Delete as applicable
If Known please give name and contact details below
If Known, please give the names of the executor(s) of the will
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*Yes / No / Not Known
*Yes / No
Has the Service User granted a power of attorney, enduring
power of attorney or lasting power of attorney
*Yes / No / Don’t know
* Delete as applicable
If Yes please state which type(s)
Date Granted
Power of attorney

Enduring power of attorney

Lasting power of attorney for property and affairs

Lasting power of attorney for personal welfare

Has the power of attorney, enduring power of attorney or lasting
power of attorney been registered with the Public Guardian
*Yes / No / Don’t know
* Delete as applicable
If Yes please state the date(s) of registration
Enduring power of attorney
Lasting power of attorney
Has there been any unsuccessful applications to register either of
the above with the Public Guardian
*Yes / No / Don’t know
Please detail below name and address of any attorneys who act (or have acted) for the
Service User
Does the Service User receive any Social security benefits
* Delete as applicable
What is the Service User’s National Insurance Number
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*Yes / No
Please give details below
Social security benefit
Weekly amount
Received by
State retirement pension
Attendance allowance
Severe disablement allowance
Disability living allowance
Incapacity benefit
Income support
Council tax benefit
Child benefit
Other type of benefit
(please give details)
Does the Service User receive any occupational/company pensions or
annuities
*Yes / No
* Delete as applicable
If Yes please give details below
Name, address and reference of the
company/payer
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Amount Received
(indicate gross or net)
Frequency of
payments
Is the Service User entitled to any income, property in the UK or abroad or
capital from a trust (i.e. where the Service User receives a benefit from such things as
property/money which is managed by someone else for their benefit, e.g., a house which is
owned by someone other than the Service User, but rented out and the Service User gets the
benefit of the rent or a lump sum of money which the Service User cannot touch, but can have
the interest from.
* Delete as applicable
*Yes / No
If Yes please give details below of any interest in a trust or similar to which the Service User
is or may become entitled.
Please give the circumstances under which the Service User will become entitled, together with details
of the property and particulars of the will or settlement and the names of the present trustees.
Does the Service User have any interest in the estate of someone who has
died or are they likely to shortly become entitled to such an interest
*Yes / No
* Delete as applicable
If Yes please give details below of any interest to which the Service User has become
entitled or may become entitled under a will or intestacy
Has the Service User recently received a damages award (e.g. following a road
accident or medical negligence) or are they expected to receive a damages
award?
*Yes / No
* Delete as applicable
If Yes please give details below including the name and address of solicitors involved on the
case and the present position with regard to the litigation. Is a settlement/trial imminent?
Has the Service User made a claim to the Criminal Injuries Compensation
Authority?
*Yes / No
* Delete as applicable
If Yes please give details below the name and address of solicitors involved on the case and
details of any awards or interim payments, including the amount.
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Please give details below of any income the Service User receives from employment
Please list below any income to which the Service User is or may become entitled which has
not been mentioned elsewhere, e.g. maintenance income.
Does the Service User have any money held in bank or building society
accounts
*Yes / No
* Delete as applicable
If Yes please give details below
(Please give details of any additional accounts on an additional sheet)
Account 1
Name and full postal
address of the
bank/building society
branch where the
account is held
Name of the account
Sort Code
Account Number
Type of account (e.g.
current, deposit,
high, interest)
How much is in the
account?
If the account is a
joint account, please
give the name and
address of the coholder
If the account is a
joint account please
give a brief
explanation of the
circumstances in
which the monies
came to be held in a
joint account.
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Account 2
Account 3
Does the other person or organisation (other than those already
mentioned) hold money for the Service User.
*Yes / No
* Delete as applicable
If Yes please give full details below including the name and address of those involved, the
amount held and the reason for holding the money.
Does the Service User own or have an interest in any investments such
as stocks and shares, unit trusts, bonds etc?
*Yes / No
* Delete as applicable
If Yes please give below full list of the investments.
Does the Service User have any life assurance policies?
* Delete as applicable
*Yes / No
If Yes please give below full details of any policies, the premiums payable and whether you
wish to continue of keep the policies going.
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Does the Service User own any land or property in the UK or abroad?
* Delete as applicable
*Yes / No
If Yes please enter below the address and state




Whether the land or property is freehold, leasehold, or commonhold property.
The approximate value of each property
If any land is owned jointly, please give details of the other joint owners and state what share of the
property is held by the Service User
If any property has a mortgage owing, please give details including the names of the people who
have taken out the mortgage, the mortgage provider and the outstanding balance.
If Leasehold please give details (if known) of the length of the lease, any rent or service
charges payable and any restriction on the sale of the property.
Please detail below any potential valuable items, if known, and where they are held, e.g.
Royal Dolton, Beswick, Wedgwood, collectable items, jewellery.
Items
Does the Service User own or have any interest in a business?
* Delete as applicable
*Yes / No
If yes please provide the name and details of the business, who is running the business, and
the role/interest of the Service User.
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Does the Service User any outstanding debts? e.g. Credit Card, loans,
utility bills, accommodation charges, disability grants repayments.
*Yes / No
* Delete as applicable
If yes please give details of any debts to the Service User including the names of any
creditors and the amounts of the debt
Name of Creditor
Amount
Does anyone owe the Service User money?
*Yes / No
* Delete as applicable
If yes please give details including who owes the money and the amounts.
Name of Person owing money
Amount
Please detail any other property in the UK or abroad or other assets which the Service User
may own or have an interest in which have not been mentioned elsewhere in this form.
If the Service User is in a nursing or residential home or some other type of accommodation
that is charged for, please state the cost of the accommodation and whether the amount is
the annual, quarterly, monthly or weekly cost.
* annual, quarterly, monthly or weekly (* Delete as applicable )
Has the Service User been assessed by the Local Authority to
pay a contribution towards their accommodation costs
* Delete as applicable
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£
* Yes / No
Please give below information about any regular gifts and regular charitable donations made
by the Service User.
Please give below any information on any recent significant expenditure made on behalf of
the Service User, either using their funds or funds provided by someone else.
Please provide below any additional background information about the Service User that is
relevant to the application (such as key dates and facts).
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List of Key Professionals involved in completion of the form
Department
Joint Finance Unit
Visiting Finance Officer
Legal Services
Social Worker / Social Care
Assessor
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Name
Date