Important:
Please read the notes
overleaf before
completing this form
Form K19 Land Charges Act 1972
APPLICATION FOR AN OFFICE COPY OF AN
ENTRY IN THE REGISTER
Fee panel
Place "X" in the appropriate box. See
Note 1 overleaf.
A cheque or postal order for
the correct fee accompanies
this application.
Please debit our Direct Debit
under an authorised agreement
with Land Registry.
Application is made for an office copy of the entry described below
Is a copy of any plan filed in the register required?
Please delete as applicable.
YES/NO
Delete words
not applicable.
PARTICULARS OF ENTRY
LAND CHARGE (Class Sub-Class )
ANNUITY
PENDING ACTION
WRIT OR ORDER
DEED OF ARRANGEMENT
Insert number and date
of the registration
Date of registration
(see Note 2 overleaf)
Day
Month
Year
Only one individual or
body to be entered.
PARTICULARS OF ESTATE OWNER
Forename(s)
SURNAME
FOR OFFICAL USE ONLY
1
#
2
OC
(See Note 3 overleaf)
KEY NUMBER
3
01
4
Solicitor’s name and
address (including
postcode).
If no solicitor is acting
enter the applicant’s
name and address
(including postcode).
(See Notes 4 and 5
overleaf)
5
Solicitor’s reference
Name and address (including postcode)
to which copy is to be sent
(Please use BLOCK CAPITALS)
This space
must be
completed
by the
applicant
Solicitor’s reference
NOTES FOR GUIDANCE OF APPLICANTS
The following notes are supplied for assistance in making the application overleaf. Detailed information for the making of all kinds of
applications to the Land Charges Department is contained in Practice Guide 63 Land Charges Applications for registration, official
search, office copy and cancellation which is obtainable on application at the address shown below.
For information on how HM Land Registry processes your personal information, see our Personal Information Charter.
1. Fees. These must be paid by Direct Debit under an authorised agreement with Land Registry or by cheque or postal order made
payable to “Land Registry” (see the Practice Guide referred to above).
2. Date of completion. Complete all boxes and refer to month by 3 letters:-
e.g.
Day
Month
Year
0
4
S
E
P
1
9
8
1
3. Key Number. If you have been allocated a key number, please take care to enter this in the space provided overleaf, whether or not
you are paying fees by Direct Debit. A key number is only available to professional customers, such as solicitors.
4. Solicitor’s reference. Any reference must be limited to 25 characters, including any oblique strokes and punctuation.
5. Despatch of this form. When completed, send this application form to the address shown below, which is printed in a position so
as to fit within a standard window envelope.
The Superintendent
Land Charges Department (see Note 5 above)
Office Copy Section
PO Box 292
PLYMOUTH PL5 2BY
DX 8249 PLYMOUTH (3)
Crown Copyright (ref: LR/HO) 05/18
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