List the documents lodged with this
form. Copy documents should be
listed separately. If you supply a
certified copy of an original document
we will return the original; if a certified
copy is not supplied, we may retain
the original document and it may be
destroyed.
Documents lodged with this form:
Enter the full name (in forename –
surname order) of the person in
respect of whom the search is to be
made. Only one name per form – a
separate form should be used in
respect of any former or alternative
name(s).
The applicant applies for a search to be made in the index of
proprietors' names in respect of:
Every address that may have been
entered in the register should be
stated.
Enter the address of the person named in panel 5:
Place 'X' in the appropriate box.
Enclose evidence of death or a
conveyancer's certificate to that
effect.
State reasons.
Entitlement to search
The applicant is
searching against their own name
searching against a company or other corporation aggregate
a personal representative of name searched
a trustee in bankruptcy of name searched
otherwise interested generally within the meaning of rule
11(3) 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(s)
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
