Use one form per document.
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 legal advice but our website
www.landregistry.gov.uk provides guidance on Land Registry
applications. This includes public guides and practice guides
(aimed at conveyancers) that can also be obtained from any Land
Registry office.
See www.landregistry.gov.uk/contact-us/offices if you are unsure
which Land Registry office to send this application to.
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.
LAND REGISTRY USE ONLY
Record of fees paid
Particulars of under/over payments
Reference number
Fees debited £
Where there is more than one local
authority serving an area, enter the
one to which council tax and
business rates are normally paid.
1
Local authority serving the property:
If the document relates to many titles,
you only need to quote one.
2
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’.
If the document relates to many
properties, you only need to quote
the property relating to the title
number quoted in panel 2.
3
Property:
Some register entries refer to
documents being filed under a
different title number.
4
Title number under which this document is filed:
5
Application and fee
Application
Fee paid (£)
See fees calculator at
www.landregistry.gov.uk/professional
/fees/fees-calculator
Official copy of an exempt information
document
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 7.
direct debit, under an agreement with Land Registry
Provide the full name(s) of the
person(s) applying for an official copy
of the exempt document. Where a
conveyancer lodges the application,
this must be the name of the client(s),
not the conveyancer.
6
The applicant:
If you are paying by direct debit, this
will be the account charged.
This is the address to which we will
normally send requisitions. However
if you insert an email address, we will
use this whenever possible.
7
This 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:
Insert date, parties and nature of
document.
8
The applicant applies for an official copy of the following
document that has been designated an exempt information
document:
9
State the reason(s) why you consider an official copy of the edited
information document is not sufficient for your purposes:
10
State why you consider that none of the information omitted from
the edited information document is prejudicial information:
OR
If you accept that some or all of the information is prejudicial
information, give details and state why you consider that the
public interest in providing an official copy of the exempt
information document outweighs the public interest in not doing
so:
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.
11
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
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
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