or act for them. If you are making an application on behalf of a registered owner, the registered owner is
Please return this form to:
Citizen Centre
PO Box 74
Gloucester
GL14 9BB
HM Land Registry may share,
check and verify the information
you are providing with:
− other government
departments and agencies
− law enforcement agencies
− other relevant organisations
and bodies and access
information relating to you
from the databases of the
organisations and bodies
mentioned above, for
verification purposes, see our
Personal Information Charter.
By providing the information
requested in this form you will be
indicating your agreement to HM
Land Registry processing your
information in this way.
If you would like further information
on this privacy policy please email
dataprotection@landregistry.gov.uk
If you dishonestly enter information
or make a statement that you know
is, or might be, untrue or
misleading, and intend by doing so
to make a gain for yourself or
another person, or to cause loss or
the risk of loss to another person,
you may commit the offence of
fraud under section 1 of the Fraud
Act 2006, the maximum penalty for
which is 10 years’ imprisonment or
an unlimited fine, or both.
Is this form open to public
inspection? The form is open to
inspection except for identity
evidence, including the date of birth
and photograph, which are
exempted from public inspection by
rule 133 of the Land Registration
Rules 2003.