LEASEHOLD REFORM, ACT 1967 Notice of tenant’s claim to acquire the freehold or an extended lease To [Name and address of person on whom this notice is served] (see Note 1 below) [and] [To: [Name and address of any recipient of a copy of this notice*] (see Note 1 below, in addition, your attention is drawn to paragraphs 8 to 10 of this notice) (*Delete if paragraphs 5 to 10 are deleted) ] 1 I am the tenant of the house and premises of which particulars are given in the Schedule to this notice. 2 In exercise of my rights under Part I of Leasehold Reform Act 1967, I give you notice of my desire: [to have the freehold of the house and premises.* OR to have an extended lease of the house and premises.*] (*Delete whichever is inapplicable.) 3 The particulars on which I rely are set out in the Schedule to this notice. 4 If you are both my immediate landlord and the freeholder, you must give me, within two months of the service of this notice, a notice in reply in Form 3