This form should be accompanied by either Form AP1 or Form FR1.
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.
For information on how HM Land Registry processes your personal information, see our Personal Information
Leave blank if this form accompanies an
application for first registration.
Title number(s) of the property:
Insert address including postcode (if
any) or other description of the property,
for example ‘land adjoining 2 Acacia
The information in panel 3 will help us if
this form becomes detached.
Insert the full name(s) of the applicant
on Form AP1/FR1. Where a
conveyancer lodges the application, this
must be the name(s) of the client(s), not
the conveyancer.
This form is lodged with an application in Form AP1/FR1 made
The registrar may enter notice of a
disclosed interest in the register of title.
You may use as many Forms DI as are
The plan to any certified copy lease
must show all colours shown on the
List below all unregistered disclosable leases in date order,
starting with the oldest.
Lodge a certified copy of either the original or counterpart of
each lease disclosed.
Notice of lease(s) will only be cancelled
on receipt of a Form CN1 with evidence
of determination.
If two or more leases of the same
property and the same date are listed,
include a number or other identifier for
each lease in the first column.
Description of land
Term and
commencement date
Flat 1, garage 3 and
bin store
5 years from
List below any disclosable overriding interests other than leases.
Lodge any documentary evidence within the control of the
applicant that identifies the interest disclosed.
For each interest disclosed in this panel:
Give a description of the interest, for
example, a legal easement.
Give details of the deed or circumstance
in which the interest arose.
Complete only if the interest affects part
of the title. Give a brief description of the
part affected, for example ‘coloured
brown on the attached plan’.
arising by virtue of:
affects the part(s) of the registered estate as shown:
arising by virtue of:
affects the part(s) of the registered estate as shown:
arising by virtue of:
affects the part(s) of the registered estate as shown:
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.
Under section 66 of the Land Registration Act 2002 most documents (including this form) kept by the registrar relating to an
application to the registrar or referred to in the register are open to public inspection and copying. If you believe a document
contains prejudicial information, you may apply for that part of the document to be made exempt using Form EX1, under rule 136
of the Land Registration Rules 2003.
© Crown copyright (ref: LR/HO) 05/18