Fill - Free fillable Ex1a Form EX1A (HM Land Registry) PDF form

This form should be accompanied by Form EX1.

This form is exempt from the general rights of inspection and copying. However, Form EX1 and any

accompanying correspondence are not exempt.

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.

Conveyancer is a term used in this form. It is defined in rule 217A, Land Registration Rules 2003 and includes

persons authorised under the Legal Services Act 2007 to provide reserved legal services relating to land

registration and includes solicitors and licensed conveyancers.

Leave blank if this application

accompanies an application for first

registration.

Title number(s) of the registered estate(s) to which the document

relates:

Insert address including postcode (if

any) or other description of the

property, for example ‘land adjoining

2 Acacia Avenue’.

Property:

The information in panels 3 and 4 will

help us if forms EX1 and EX1A

become detached.

Provide the full name(s) of the

person(s) applying to exempt the

document. Where a conveyancer

lodges the application, this must be

the name(s) of the client(s), not the

conveyancer.

Enter the name of the applicant on the accompanying EX1:

This is the address to which we will

normally send requisitions. However

if you insert an email address, we will

use this whenever possible.

The EX1 application is sent to Land Registry by

Key number (if applicable):

Name:

Address or UK DX box number:

Email address:

Reference:

Phone no:

Fax no:

'Prejudicial information' means—

(a) information that relates to an

individual who is the applicant under

rule 136 and if disclosed to other

persons (whether to the public

generally or specific persons) would,

or would be likely to, cause

substantial unwarranted damage or

substantial unwarranted distress to

the applicant or another, or

(b) information that if disclosed to

other persons (whether to the public

generally or specific persons) would,

or would be likely to, prejudice the

commercial interests of the applicant

under rule 136.

State why you believe that the information contained in the

document referred to on the accompanying Form EX1 is

prejudicial information defined in rule 131 of the Land Registration

Rules 2003:

If a conveyancer is acting for the

applicant, that conveyancer must

sign. If no conveyancer is acting, the

applicant (and if more than one

person then each of them) must sign.

Signature of applicant

or their conveyancer:

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

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Fillable Ex1a Form EX1A (HM Land Registry)

Fill Online, Printable, Fillable, Blank Ex1a Form EX1A (HM Land Registry) Form

Use our library of forms to quickly fill and sign your Land Registry forms online.

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