Use one form per title.
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 or business
rates are normally paid.
1
Local authority serving the property:
2
Title number(s) of the property:
Insert address including postcode (if
any) or other description of the
property, for example ‘land adjoining
2 Acacia Avenue’.
3
Property:
4
Application and fee
Fee paid (£)
See fees calculator at
www.landregistry.gov.uk/professional
/fees/fees-calculator
rights
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 5.
direct debit, under an agreement with Land Registry
If you are paying by direct debit, this
will be the account charged.
5
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:
Enter the full names. If there are
more than two persons, enter the first
two.
6
Registered proprietor(s)
SURNAME:
FORENAME(S):
SURNAME:
FORENAME(S):
A mortgagee does not have to be
registered or otherwise protected on
the register.
7
Full name of applicant mortgagee:
8
Application is made for an official certificate of the result of a
search of the register of the title in panel 2 for the purpose of
section 56(3) of the Family Law Act 1996 to ascertain whether a
home rights notice or matrimonial home rights caution is entered
in that register and whether there is a pending application for the
entry of a home rights notice entered on the day list.
9
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) 10/13
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