Any parts of the form that are not typed should be completed in black ink and in block capitals.
For information on how HM Land Registry processes your personal information, see our Personal Information
Charter.
Use one form for each charge. You must supply two copies of the charge with this application.
Insert address(es) including postcode
(if any) of the applicant.
Address:
Reference:
Phone no:
Email address:
Give full name(s),
Complete as appropriate where the
lender is a company. Also, for an
overseas company, unless an
arrangement with HM Land Registry
exists, lodge a certified copy of the
constitution in English or Welsh, or
other evidence permitted by rule 183
of the Land Registration Rules 2003.
A lender must give its legal name
exactly as registered in Companies
House or where the lender is a
foreign company within the meaning
of the Companies Act 2006 the full
legal name as registered in its state
of incorporation.
Lender for entry in the register:
For UK incorporated companies/I&PS
Companies House or I&PS registration number including any
prefix and or suffix:
For overseas companies
(a) Territory of incorporation:
(b) Registered number in England and Wales including the prefix
FC or BR as registered at Companies House:
Place 'X' in the box(es) if appropriate.
See Practice Guide 30 – Approval of
mortgage documentation for a
definition of a standard restriction.
The charge contains a standard restriction in clause:
The charge contains an application for entry of an obligation
to make further advances in clause:
Each lender may give up to three
addresses for service, one of which
must be a postal address whether or
not in the UK (including the postcode,
if any). The others can be any
combination of a postal address, a
UK DX box number or an electronic
address.
Once the charge has been approved,
we will only enter the address(es) for
service as given on this form on
registration of the charge. Any other
addresses given on an application to
register the approved charge will be
ignored. See the undertaking in panel
7.
Lender’s intended address(es) for service for entry in the register: