Provide the full name(s) of the
person(s) applying to remove the
deceased proprietor from the
register. Where a conveyancer
lodges the application, this must be
the name(s) of the client(s), not the
This is the address to which we will
normally send requisitions and return
documents. However if you insert an
email address, we will use this
whenever possible. Where an
application is lodged by e-DRS all
documents and correspondence will
be dealt with electronically.
This application is sent to Land Registry by
Key number (if applicable):
Address or UK DX box number:
Place 'X' in the appropriate box.
I/We as solicitor(s) for:
hereby apply to remove from the register the name of:
who died on:
Complete this certificate only if the
deceased proprietor died at an
address which is different from that
given in panel 3.
I/We certify that:
is the same person as:
described in the register of the title number shown in panel 2
If a conveyancer is acting for the
applicant, that conveyancer must
sign. If no conveyancer is acting, the
applicant (and if the applicant is more
than one person then each of them)
Signature of applicant:
or their conveyancer
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) 06/14