Place 'X' in the box against each of the
statements being made, and complete
the final statement if it is being made.
You must make the first four statements,
otherwise your application may be
cancelled.
Place 'X' in the box against each of the
statements being made, and complete
the final statement.
You must make all these statements,
and complete the final statement,
otherwise your application may be
cancelled.
Insert full details.
If the application is under paragraph 6 of Schedule 6 to the
Land Registration Act 2002 (as applied to rentcharges by rule
191 of, and Schedule 8 to, the Land Registration Rules 2003)
AND you are the applicant
Paragraph 6(2) of Schedule 6 to the Land Registration
Act 2002 does not apply
I confirm that to the best of my knowledge the restriction
on applications in paragraph 8 of Schedule 6 to the Land
Registration Act 2002 does not apply
I confirm that to the best of my knowledge the rentcharge
is not, and has not been during any of the period of
claimed adverse possession, subject to a trust (other
than one where the interest of each of the beneficiaries is
an interest in possession)
I confirm that that the proprietor of the registered
rentcharge has not re-entered the land out of which the
rentcharge issues
The full details of the rejected application are as follows:
If the person making the statement is
unable to sign it, this wording will need to
be amended to comply with rule 215A(5)
and (6) of the Land Registration Rules
2003. In addition, and in cases where
the person making the statement is
unable to read, there will need to be an
appropriate certificate: see rule 215A(4)
and (5).
Where the application is being made
under Schedule 6 and the person
making this statement, or on whose
behalf it is made, is the applicant, the
statement must be made not more than
one month before the date of the
application.
I believe that the facts and matters contained in this statement
are true
Signature (of person
making this statement):
Print full name:
Date:
WARNING
If the application proceeds, notice of the application (accompanied by a copy of this statement of truth) may be sent by the
registrar to the owner of the land or any person thought to be the owner and/or any other person upon whom the registrar
considers it necessary or desirable to serve notice.
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) 05/18
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