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.
If a joint statement is made by two or more persons, consequential amendments can be made to the text in the
panels (for example, ‘I’ can be changed to ‘we’).
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.
Insert full name.
Insert full address.
1 I:
of:
make this statement in support of an application to Land
Registry based upon adverse possession of a rentcharge
Place 'X' in one box only.
This is for cases where the squatter is a
company or firm, someone who has
died, or is otherwise incapable of making
the statement personally. Insert the
name and address of the squatter.
Insert reasons and describe the
relationship of the person making the
statement to the person on whose behalf
it is made. Enclose any relevant
documentation (for example, office copy
g
rant of probate
)
.
2 Status
I am
the person currently in adverse possession of the
rentcharge
a person who was previously in adverse possession of
the rentcharge
making this statement on behalf of:
who is currently or was previously in adverse possession but
who cannot make this statement for the following reasons:
Place 'X' in the appropriate box and
complete the relevant statement.
Insert address including postcode (if
any) or other description of the property
out of which the rentcharge issues, for
example ‘land adjoining 2 Acacia
A
venue’.
Insert title number(s).
3 Details of the rentcharge
The rentcharge is registered under title number(s):
The rentcharge is not registered
Place ‘X’ in one of the two boxes.
Insert details of any formal
apportionment and enclose relevant
documentation.
4
A
pportionment
The rentcharge does not affect other property
The rentcharge was formally apportioned by:
Insert the dates the adverse possession
started and finished. Any ‘gaps’ must be
specified if the period is not continuous.
Only include the period of adverse
possession by the person making this
statement or on whose behalf it is made.
5 Period of adverse possession of the rentcharge:
Inse
r
t details of the acts relied on.
Unless non-payment is being claimed,
give details of all the payments of the
rent to you or the person on whose
behalf this statement is made (including
amounts and dates), and details of the
rent paid to anyone else.
6
A
cts of adverse possession of the rentcharge:
Place 'X' in the appropriate box(es) and
complete the statement if appropriate.
Insert details, including the date of expiry
or determination.
Insert details.
7 Permission to possess the rentcharge
The possession of the rentcharge has been
without the consent, licence or permission of anybody at
any time
by virtue of the following consent, licence or permission
which has expired or determined:
by virtue of the following consent, licence or permission:
Insert name and address of any known
owner of the rentcharge or person
thought to be the owner and/or
mortgagees. If not known, please state
this by inserting ‘not known’. If the
rentcharge is unregistered, copies of any
title deeds or other relevant
documentation should be lodged, if
available.
8 Details of any known owner of the rentcharge or person
thought to be the owner and related persons:
Insert details of any past or present
contact with the owner of the rentcharge
or person thought to be the owner and/or
mortgagees of that person, including
dates. If none, please state this by
inserting ‘none’. If there has been any
dispute concerning the adverse
possession, insert details, including
dates. Attach copies of all available
correspondence or other documents
relating to the contact or dispute.
9 Contact with owner of the rentcharge and related persons
Insert other relevant details, (if any).
10 Other
r
elevant details
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.
Insert details of the facts.
11
If the application is under paragraph 1 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 1(2) of Schedule 6 to the Land Registration
Act 2002 does not apply
I confirm that that the proprietor of the registered
rentcharge has not re-entered the land out of which the
rentcharge issues
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)
Should a person given notice under paragraph 2 of
Schedule 6 to the Land Registration Act 2002 require the
application to be dealt with under paragraph 5 of that
Schedule, the facts supporting my reliance on one or
both of the conditions set out in that paragraph are as
follows:
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.
12 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.
13 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 necessar
y
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 re
ister.
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 Re
g
istration Rules 2003.
© Crown copyright (ref: LR/HO) 10/12
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome