Any parts of the form that are not typed should be completed in
black ink and in block capitals.
If you need more room than is provided for in a panel, and your
software allows, you can expand any panel in the form. Alternatively
use continuation sheet CS and attach it to this form.
HM Land Registry is unable to give legal advice, but you can find
guidance on HM Land Registry applications (including our practice
guides for conveyancers) at. www.gov.uk/land-registry
Conveyancer is a term used in this form. It is defined in rule 217A,
Land Registration Rules 2003 and includes persons authorised
under the Legal Services Act 2007 to provide reserved legal services
relating to land registration and includes solicitors and licensed
For information on how HM Land Registry processes your personal
information, see our Personal Information Charter.
HM LAND REGISTRY USE ONLY
Record of fees paid
Particulars of under/over payments
Fees debited £
Where there is more than one local
authority serving an area, enter the one
to which council tax or business rates are
Local authority serving the property:
Title number(s) of the property:
Insert address including postcode (if any)
or other description of the property, for
example ‘land adjoining 2 Acacia
To find out more about our fees visit
Place 'X' in the appropriate box.
The fee will be charged to the account
specified in panel 7.
Noting of agreed maximum
amount of security
cheque made payable to 'Land Registry'
direct debit, under an agreement with Land Registry
If there are two or more charges of the
same date to the same lender, you must
clearly identify under which charge the
agreement is contained by including a
number or other identifier for the charge
in the first column.
Details of the registered charge containing the agreement
Date of entry in
Provide the full name(s) of the person(s)
applying to enter the note. Where a
conveyancer lodges the application, this
must be the name(s) of the client(s), not