Form 16.7 
 
Form of certificate of intimation of a document 
 
I, (name and designation), certify that I intimated (specify document) to (name of person to whom intimation made) [with a copy of the interlocutor of Lord (name) dated (date) a copy of which is attached] on (date).   
 
      (Signed) 
 
      Solicitor [or Agent] for pursuer 
      [or as the case may be] 
      (Address)