Form 4	Notice under the Common Boundaries Act 1981, section 6 (3)
Common Boundaries Act 1981

To (name and address)

1	You are invited to discuss the *[repair/replacement] of the fence between the land occupied by you at (address) and the adjoining land situated at (address) with a view to reaching agreement about the work and contribution to the cost of it.
2	If an agreement cannot be reached within 1 month after the day I gave you this notice, an application will be made to the Small Claims Court for a determination under the Common Boundaries Act 1981, section 7 in relation to the *[repair/replacement] of the fence between the parcels of land referred to above.

Date:

(signature of person giving notice)
(name of person giving notice)
(address of person giving notice)