Any parts of the form that are not typed should be completed in
black ink and in block capitals.
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.
HM Land Registry is unable to give legal advice but our website
www.landregistry.gov.uk provides guidance on HM 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 HM 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.
HM 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:
Full postcode of property (if any):
2
Title number(s):
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
Application
Fee paid (£)
Return of original document(s)
Fee payment method
cheque made payable to 'HM Land Registry'
direct debit, under an agreement with HM Land Registry
Provide the full name(s) of the
person(s) requesting the return of the
document(s). Where a conveyancer
lodges the application, this must be
the name(s) of the client(s), not the
conveyancer.
5
The applicant:
This is the address to which we will
normally send requisitions and return
documents. However if you insert an
email address, we will use this
whenever possible.
6
This application is sent to HM Land Registry by
Key number (if applicable):
Name:
Address or UK DX box number:
Email address:
Reference:
Fax no:
If the document(s) you require is/are
specifically mentioned in the register
provide full details of the document(s)
you wish to be returned, i.e. the date,
type of document (conveyance,
transfer and so on) and parties.
7
I/We request the return of the following original document(s)
specifically referred to in the register:
If the document(s) you require is/are
not specifically referred to in the
register, provide as full a description
as possible, i.e. the approximate date
and nature of the transaction(s)
registered at the time.
8
I/We request the return of the following original document(s) not
specifically referred to in the register:
If a conveyancer is acting for the
applicant, that conveyancer must
sign. If no conveyancer is acting, the
applicant (and if the applicant is more
than one person then each of them)
must sign.
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) 04/17
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