Rent Distraint Authorisation Form

To C. N. GAUNT & SON or their assistants.

Landlord:	*
I/We do hereby authorise you to distrain the goods and chattels of :-
Tennant:	*
on the premises now in his/her/their possession, situated at
Address of Tennant:	*

Town/City:	*
County:	*
Postcode:	*
being Rent Insurance Services due from the same, to me
for the sum of (£):	*
Date Rent Due:	*
Date amount covers up until:	*
For doing so this shall be sufficient warrant of authority, and I further undertake to hold you harmless in respect of the said distraint and from all legal proceedings connected therewith.
Contact Name:	* Solicitor Landlord Agent
Address:	*

Town/City:	*
County:	*
Postcode:	*
Telephone No:	*
Email Address:	*
Reference:	*
	* required fields

Verification:
	Type the code displayed above in the box.
LEGAL NOTICE: By submitting these details electronically you are confirming that you agree to the terms and conditions and that to the best of your knowledge the contents of the form are true, and that you wish to engage the services of CNG to distrain.

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