THE UNITED REFORMED CHURCH  (SOUTHERN PROVINCE) TRUST LTD

APPLICATION under MANSE POLICY (Manse Form)

Refer to Manse Policy before completing.
Please submit electronically where possible or send one completed copy to the Synod Office

FOR COMPLETION BEFORE CARRYING OUT WORK – IN EMERGENCIES CONTACT SYNOD PROPERTY OFFICER

1. CHURCH/PASTORATE NAME:
     CHURCH NO(s):

If Pastorate Name, list Churches:

1.
2.

Church Contact:  Name:
  Address:
  Postcode:
  Tel. No:
  E mail:

2. MANSE DETAILS

A. ADDRESS OF PROPERTY:
B. RATING AUTHORITY:
C. DATE OF LAST SURVEY: i) Property
    ii) Electrical
    iii) Gas
D. INSURANCE DETAILS: i) Company:
    ii) Insurance Value £
E. IS MANSE IN A CONSERVATION AREA?
F. OCCUPIED?

3. NATURE OF ACTION (Please indicate):

4. RESOLUTION OF CHURCH MEETING at Church Meeting held on

N0. AT MEMBERS ON ROLL:  N0. AT CHURCH MEETING:

VOTING AT THE MEETING:     FOR: AGAINST: ABSTAINED:

4. IS THE LOCAL ACT AWARE OF THIS APPLICATION?

5. DESCRIPTION OF WORK REQUIRED

6. REASON FOR UNDERTAKING THIS WORK

7. DETAILS OF COSTS (Please provide minium two estimates)

Preferred Supplier:

                                                                     Cost £ (inc VAT if applicable)

8. OFFICE USE – SYNOD CHECKLIST

A) Estimates Supplied
B) Manse details checked
C) If Let – check we have a copy of Letting Agreement

9. SYNOD ACTION

AGREED
GRANT GIVEN £
Church Informed
Date

 

Signed: Date:
 
Synod Property Officer