PLEASE NOTE - this is not a form to fill in, but an example which will assist you in preparing your statement.

Deposit of Statement and Plan

Section 31(6), Highways Act 1980

To Hampshire County Council:  

1. I  am and have been since (day, month, year) the owner within the meaning of the above section of the land known as (name of farm, etc.) more particularly delineated on the plan accompanying this statement and thereon edged red.
2. The aforementioned land lies in the Parishes/Communities of (name) and (name).
3. * The ways coloured brown on the said plan have been dedicated as highways for all purposes.
4. * The ways coloured broken green on the said plan have been dedicated as restricted byways
5. * The ways coloured green on the said plan have been dedicated as bridleways.
6. * The ways coloured purple on the said plan have been dedicated as footpaths.
7. * No (other) ways over the land have been dedicated as highways.
8. The deposit shall comprise this statement and accompanying plan.

(*   Delete as applicable)

Signed (landowner)

Name (landowner)

Address

Date

Signed (witness)

Name (witness)

Address

Occupation