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This Indenture, made the Day of in the Year between A. B., Lord of the Manor of of the One Part, and C. D. of in the County of a Tenant of the said Manor, of the other Part: Whereas on or about the Day of the said [Tenant] was admitted Tenant to the Lands Parcel of the said Manor described in the Schedule hereto, upon an absolute Surrender passed to his Use by [or by virtue of a Bargain and Sale from or by virtue of the Will of or as Customary Heir of as the Case may be]: Now this Indenture witnesseth, That in consideration of the Sum of Pounds Sterling by the said [Tenant] to the said [Lord] now paid, the Receipt of which the said [Lord] hereby acknowledges [or in consideration of the Rentcharge to be reserved, as the Case may be], he the said [Lord], in exercise of any Power given him by the said Copyhold Acts, or any other Power whatsoever, and with the Consent of the Copyhold Commissioners, hereby enfranchises and releases unto the said [Tenant], his Heirs and Assigns, all the Lands to which, the said [Tenant] was so admitted Tenant as herein-before recited, and which are described in the Schedule hereto, together with their Appartenances, To hold the said Lands (subject to the [here state the gross Sum of Money or Rentcharge] secured to the said by the Certificate of the Copyhold Commissioners, as the Case may repairs,) unto the said [Tenant], his Heirs and Assigns [here state any Uses which may be required], as Freehold, henceforth and for ever, discharged by these Presents from all Fines, Heriots, Reliefs, Quitrents, and all other Incidents whatsoever of Copyhold or Customary Tenure: Provided always, that nothing in this Deed contained shall prejudice or affect the Rights or Remedies of the said [Lord] in respect, of any Lands held of the said Manor, other than those comprised in the Schedule hereto, nor any of the Rights reserved by the Copyhold Act, 1852, Section Forty-eight. In witness, &c.
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