8. Where you would like us to deal with someone else We shall deal only with the applicant, or the person lodging the application
if different, unless you place “X” against one or more of the statements below and give the necessary details.
Send title information document to the person shown below
Raise any requisitions or queries with the person shown below
Return original documents lodged with this form (see italic text in panel 6) to the person shown
If this applies only to certain documents, please specify.
Telephone No. Fax No.
9. Full name(s) and address(es) for service of every applicant for entry on the register. The
address(es) will be entered on the register and used for correspondence and the service of notices.
You may give up to three addresses for service one of which must be a postal address but does not have to be within the UK. The other
addresses can be a combination of either a postal address, a box number at a UK document exchange or an electronic address. For a
company include company’s registered number, if any. For Scottish companies use an SC prefix and for limited liability partnerships use
an OC prefix before the registered number, if any. For foreign companies give territory in which incorporated.
10. Information in respect of any new charge
Do not give this information if a Land Registry MD reference is printed on the charge, unless the charge has been transferred.
Full name and address (including postcode) for service of notices and correspondence of the person to be
registered as proprietor of each charge. You may give up to three addresses for service. See panel 9 as to the details you should
Unless otherwise arranged with Land Registry Head Office, we require a certified copy of the chargee’s constitution (in English or Welsh)
if it is a body corporate but is not a company registered in England and Wales or Scotland under the Companies Acts.
11. Name, address(es) and company registration number of the commonhold association If it is not the
applicant. See panel 9 as to the details you should include.
12. Signature of applicant
or their conveyancer
The completion of this panel on the form is voluntary. No individual property or person will be
identified from the information given. The information will be used by Land Registry to improve its
forecasting and may be supplied to the Ministry of Justice. Place “X” in the appropriate box.
The property the subject of this application is
residential non-residential mixed
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