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.
Land Registry is unable to give specific legal advice but we do provide guidance on Land Registry
applications on our website www.landregistry.gov.uk. This includes public guides and practice guides (aimed
at conveyancers) that can also be obtained from any Land Registry office.
1
Fee payment method
Place 'X' in the appropriate box.
cheque made payable to 'Land Registry'
The fee will be charged to the
account specified in panel 2.
direct debit, under an agreement with Land Registry
If you are paying by direct debit, this
will be the account charged.
If you insert an email address we will
normally contact you using only this
address.
2
This application is sent to Land Registry by
Key number (if applicable):
Name:
Address or UK DX box number:
Email address:
Reference:
Phone No.
Part 1 - Application
3
I apply
Place 'X' in the appropriate box(es).
to inspect the register and/or document(s) identified in
the attached Form PIC
for official copy/copies of the register/plan identified in
the attached Form OC1
for official copy/copies of the document(s) identified in
the attached Form OC2
for copy/copies of the historical edition(s) of the
register/title plan identified in the attached Form HC1
for a search of the index map as set out in the
attached Form SIM
for a search of the index of relating franchises and
manors as set out in the attached Form SIF
for a search in the index of proprietors’ names as set
out in the attached Form PN1
for a search in the index of proprietors’ names as set
out in the attached Form PN1 and for official copies of
all registers identified in the results of that search
You must also complete the
appropriate certificate in Part 2 of
this form.
4
Signature of applicant:
Print full name:
Date:
WARNING
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.
Failure to complete this form with proper care may result in a loss of protection under the Land Registration Act 2002 if, as
a result, a mistake is made in the register.
Part 2 Certificates Place “X” in the box(es) for the appropriate certificate and complete any blank spaces in
respect of that certificate. Where the method of production allows, you may omit all of the following 15 panels other than
the one containing the appropriate certificate.
CERTIFICATE A General criminal investigations.
I certify that a criminal offence namely
contrary to
has been or is reasonably suspected to have been committed and there is reason to believe that the
required information may be relevant to the investigation of the offence or to the institution of proceedings for
it.
CERTIFICATE B Recovery or distribution of proceeds of general crime.
I certify that on at Court
the following person(s)
was/were convicted of (a) criminal offence(s)
namely
contrary to and the following offences
were taken into consideration
and there is reason to believe that the required information may be relevant to the institution of proceedings
for making available for distribution or otherwise for recovering the proceeds of the commission of that/those
offence(s).
I am
(Certificates A or B only)
a Chief Officer of Police or a police officer authorised to apply on behalf of a Chief Officer.
the Director of Public Prosecutions or a member of the Crown Prosecution Service authorised to
apply on behalf of the Director.
the Director of the Serious Fraud Office or a member of the Serious Fraud Office authorised to apply
on behalf of the Director.
a person authorised to apply by the Secretary of State for Work and Pensions.
a person authorised to apply by the Secretary of State for Business, Innovation and Skills.
an officer of Revenue and Customs.
the Director of Revenue and Customs Prosecutions or a member of the Revenue and Customs
Prosecutions Office authorised to apply on behalf of the Director.
CERTIFICATE C Investigation into drug trafficking offences as defined in the Drug Trafficking Act 1994.
I certify that there are reasonable grounds for suspecting that the required information is likely to be of
substantial value (whether by itself or together with other information) to an investigation into drug trafficking
as defined in section 1(3) of the Drug Trafficking Act 1994.
CERTIFICATE D Investigation into whether a person has benefited from drug trafficking or to facilitate the
recovery of the value of proceeds of drug trafficking.
I certify that has committed or there are reasonable grounds for
suspecting that that person has committed a drug trafficking offence as defined in section 1(3) of the Drug
Trafficking Act 1994 and that I have reasonable grounds for suspecting that the required information is likely
to be of substantial value (whether by itself or together with other information) to an investigation into
whether that person has benefited from drug trafficking or in facilitating the recovery of the value of his
proceeds of drug trafficking.
I am
(Certificates C or D only)
a Chief Officer of Police or a police officer authorised to apply on behalf of a Chief Officer.
the Director of Public Prosecutions or a member of the Crown Prosecution Service authorised to
apply on behalf of the Director.
an officer of Revenue and Customs.
the Director of Revenue and Customs Prosecutions or a member of the Revenue and Customs
Prosecutions Office authorised to apply on behalf of the Director.
the Lord Advocate or a person conducting a prosecution in Scotland on behalf of the Lord Advocate.
CERTIFICATE E Investigation into whether a person has benefited from an offence referred to in the
certificate or to facilitate the recovery of the value of property obtained by that person from that offence: Criminal Justice
Act 1988.
I certify that has committed or there are reasonable grounds for
suspecting that that person has committed or there are reasonable grounds for suspecting that a person has
committed an offence to which Part VI of the Criminal Justice Act 1988 applies and that I have reasonable
grounds for suspecting that the required information is likely to be of substantial value (whether by itself or
together with other information) to an investigation into whether that person has benefited from the said
offence or in facilitating the recovery of the value of the property obtained by that person from or in
connection with the said offence.
I am
a Chief Officer of Police or a police officer authorised to apply on behalf of a Chief Officer.
the Director of Public Prosecutions or a member of the Crown Prosecution Service authorised to
apply on behalf of the Director.
an officer of Revenue and Customs.
the Director of the Serious Fraud Office or a member of the Serious Fraud Office authorised to apply
on behalf of the Director.
the Director of Revenue and Customs Prosecutions or a member of the Revenue and Customs
Prosecutions Office authorised to apply on behalf of the Director.
a person authorised to apply by the Secretary of State for Business, Innovation and Skills.
CERTIFICATE F To assist the Security Service in the performance of its functions.
I certify that there are reasonable grounds for believing that the required information is likely to be of
substantial value (whether by itself or together with other information) in assisting the Security Service in
performing its functions under section 1 of the Security Service Act 1989.
I am the Director General of the Security Service or a member of the Security Service authorised to apply on
behalf of the Director General.
CERTIFICATE G Terrorist investigation.
I certify that there are reasonable grounds for suspecting that the required information is likely to be of
substantial value (whether by itself or together with other information) to a terrorist investigation to which
section 32 of the Terrorism Act 2000 applies.
I am
a Chief Officer of Police or a police officer authorised to apply on behalf of a Chief Officer.
CERTIFICATE H Investigation under the Proceeds of Crime Act 2002: Confiscation.
I certify that is the subject of an investigation into whether he
has benefited from his criminal conduct, or the extent or whereabouts of his benefit from his criminal
conduct; that there are reasonable grounds for suspecting that he has benefited from his criminal conduct;
and that there are reasonable grounds for believing that the required information is likely to be of substantial
value (whether or not by itself) to the investigation.
I am
a constable.
an officer of Revenue and Customs.
the Director General of the National Crime Agency or a National Crime Agency officer authorised to
apply on behalf of the Director General.
an accredited financial investigator falling within section 378(1)(b) of the Proceeds of Crime Act
2002.
the Director of Revenue and Customs Prosecutions or a member of the Revenue and Customs
Prosecutions Office authorised to apply on behalf of the Director.
the Lord Advocate or a person conducting a prosecution in Scotland on behalf of the Lord Advocate.
CERTIFICATE I Investigation under the Proceeds of Crime Act 2002: Civil recovery.
I/we certify that
(give details of the property)
is the subject of an investigation into whether it is recoverable or associated property (within the meaning of
Part 5 of the Proceeds of Crime Act 2002), who holds such property, or its extent or whereabouts; that there
are reasonable grounds for suspecting that that property is recoverable or associated property; and that
there are reasonable grounds for believing that the required information is likely to be of substantial value
(whether or not by itself) to the investigation.
I am/we are
the Director General of the National Crime Agency or a National Crime Agency officer authorised to
apply on behalf of the Director General.
apply on behalf of the Director.
the Director of Public Prosecutions or a member of the Crown Prosecution Service authorised to
the Director of Revenue and Customs Prosecutions or a member of the Revenue and Customs
Prosecutions Office authorised to apply on behalf of the Director.
the Director of the Serious Fraud Office or a member of the Serious Fraud Office authorised to apply
on behalf of the Director.
the Scottish Ministers or a person named by them.
CERTIFICATE J To facilitate an exercise of powers by a receiver or administrator appointed under the
Drug Trafficking Act 1994, Criminal Justice Act 1988, Proceeds of Crime Act 2002 or Criminal Justice (Scotland) Act
1987.
I certify that I am a receiver appointed under sections 26 or 29 of the Drug Trafficking Act 1994, Part VI of
the Criminal Justice Act 1988 or sections 48, 50, 52, 196, 198, 200 or 246 of the Proceeds of Crime Act
2002 or an administrator appointed under section 13 Criminal Justice (Scotland) Act 1987 or sections 125,
128 or 256 of the Proceeds of Crime Act 2002 and the enclosed document certified by a proper officer of the
Court is a true copy of the Order appointing me to be a receiver or administrator and I have reasonable
grounds for suspecting that the required information is likely to facilitate the exercise of the powers conferred
on me in respect of the following person or property:
CERTIFICATE K In connection with insolvency.
I certify that there is reason to believe that the required information would be of assistance to me in carrying
out my functions as an Official Receiver, Official Assignee, Liquidator, Administrator or Trustee in
Bankruptcy of
I am
the Official Receiver.
the Official Assignee.
the Liquidator.
the Administrator.
the Trustee in Bankruptcy.
CERTIFICATE L In connection with the assessment, or the amount, of tax liability.
I certify that I believe on reasonable grounds that the required information is or may be relevant to any tax
liability to which a person is or may be, or may have been, subject, or to the amount of any such liability.
I am authorised to apply by the Commissioners for Her Majesty’s Revenue and Customs and have the
consent of a General/Special Commissioner to make this application.
CERTIFICATE M National Crime Agency in connection with the assessment, or the amount of tax liability.
I certify that I believe on reasonable grounds that the required information is or may be relevant to any tax
liability to which a person is or may be, or may have been, subject or to the amount of any such liability, and
that the General Revenue functions (as defined in section 323 of the Proceeds of Crime Act 2002) in relation
to that person vest in the National Crime Agency.
I am the Director General of the National Crime Agency or a National Crime Agency officer authorised to
apply on behalf of the Director General.
CERTIFICATE N In connection with money laundering offences.
I certify that is the subject of a money laundering investigation for the
purposes of Part 8 of the Proceeds of Crime Act 2002, that there are reasonable grounds for suspecting that
that person has committed an offence referred to in section 415 of the Act (money laundering offences), and
that there are reasonable grounds for believing that the required information is likely to be of substantial
value (whether or not by itself) to the investigation.
I am
a constable.
an officer of Revenue and Customs.
an accredited financial investigator falling within section 378(4)(a) of the Proceeds of Crime Act
2002.
the Lord Advocate or a person conducting a prosecution in Scotland on behalf of the Lord Advocate.
CERTIFICATE O To assist the National Crime Agency in the performance of its functions.
I certify that there are reasonable grounds for believing that the required information is likely to be of
substantial value (whether by itself or together with other information) in assisting the National Crime Agency
in discharging one or more of its functions under section 1 of the Crime and Courts Act 2013.
I am the Director General of the National Crime Agency or a National Crime Agency officer authorised to
apply on behalf of the Director General.
CERTIFICATE P In connection with the Environment Act 1995.
I certify that the required information is required by me in the execution of my powers or duties
under or by virtue of section 108 of the Environment Act 1995.
I am an authorised person within the meaning of section 108(15) of the Environment Act 1995,
acting under the written authority of:
[name of enforcing authority as defined in section 108(15)]
CERTIFICATE Q To assist the Financial Services Agency in the performance of its functions.
I certify that:
a criminal offence which the Financial Services Authority has power to prosecute under the Financial
Services and Markets Act 2000 ("the 2000 Act"),
a contravention of a requirement imposed by or under any enactment and enforceable by the
Financial Services Authority, or
market abuse for the purposes of the 2000 Act
has taken place or is reasonably suspected to have taken place, and there is reason to believe that the
required information may be relevant to the investigation of the offence, contravention or market abuse or to
the institution of proceedings relating to it.
I am the Director of Enforcement at the Financial Services Authority or a member of the Financial Services
Authority authorised to apply on behalf of the Director of Enforcement.
© Crown copyright (ref: LR/HO) 10/13
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