Fillable Land Registry - AC4 - Certificate of cancellation

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Certificate of cancellation

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The Land Registry - AC4 - Certificate of cancellation form is 1 page long and contains:

  • 1 signature
  • 0 check-boxes
  • 9 other fields

Country of origin: UK
File type: PDF

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• For information on how HM Land Registry processes your personal information, see our Personal Information Charter.
(1) Please insert name of
farmer, farmers or society.
Where there are two or more
farmers entered on the
Register continue on the back
of this form.
I/We apply for a certificate that the registration of an
Agricultural Charge which was registered at the Land Registry
against the following name or names has been cancelled.
Forename(s)
(1)
Surname
Date of registration
Reference number
Signature of Applicant or his solicitor Date
Certificate
It is certified that the above registration has been cancelled.
on
under Reference No.
Official stamp
Key Number
Applicant’s name and address
(including postcode)
(2)
(2) This is the address to
which the official
certificate will be sent.
(3) Please limit to 25
characters including oblique
strokes and punctuation.
Applicant’s
reference
(3)
Telephone
Number
Crown copyright (ref: LR/HQ) 05/18
Application for
a certificate that
a registration has
been cancelled
HM Land Registry
AC4
(Agricultural Credits Act 1928)
• Please complete the white boxes in typescript or
BLOCK LETTERS using black ink that will not
smear. No covering letter is necessary.
• Fees must be paid by variable direct debit account
or by cheque or Postal Order, made payable to
‘Land Registry’.
• The address panel below is printed in a position so
as to fit within a standard window envelope.
For official use only
Official number
The Superintendent
Agricultural Credits Department
PO Box 292
PLYMOUTH PL5 9BY
DX8249 PLYMOUTH 3
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Land Registry - AC4 - Certificate of cancellation

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Completed 22 January 2019

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