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 you can find
guidance on HM Land Registry applications (including our practice
guides for conveyancers) at www.gov.uk/land-registry.
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.
For information on how HM Land Registry processes your personal
information, see our Personal Information Charter.
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:
2
Title number(s) of the property:
Insert address including postcode (if any)
or other description of the property, for
example ‘land adjoining 2 Acacia
Avenue’.
3
Property:
To find out more about our fees visit
www.gov.uk/government/collections/fees-
land-registry-guides
Place 'X' in the appropriate box.
The fee will be charged to the account
specified in panel 7.
4
Application and fee
Application
Fee paid (£)
Registration as beneficiary of
existing unilateral notice
Fee payment method
cheque made payable to 'Land Registry'
direct debit, under an agreement with Land Registry
List the documents lodged with this form,
please note that supporting documents
need not be lodged if the conveyancer
lodging the application certifies the
details in panel 11 of this form. If this
application is accompanied by Form AP1
please only complete the corresponding
panel on Form AP1 or DL (if used). We
only need certified copies of deeds or
documents you send to us with HM Land
Registry application forms. Once we
have made a copy of the documents you
send to us, they will be destroyed, this
applies to both originals and certified
copies.
5
Documents lodged with this form:
Provide the full name(s) of the
person(s) applying to be registered as
beneficiary. Where a conveyancer
lodges the application, this must be
the name(s) of the client(s), not the
conveyancer.
Complete as appropriate where the
applicant is a company.
6
The applicant:
For UK incorporated companies/LLPs
Registered number of company or limited liability partnership
including any prefix:
For overseas companies
(a) Territory of incorporation:
(b) Registered number in the United Kingdom including any prefix:
This panel must always be completed.
A key number is only available to
professional customers, such as
solicitors.
If you are paying by direct debit, this
will be the account charged.
This is the address to which we will
normally send requisitions. However if
you insert an email address, we will
use this whenever possible. Where an
application is lodged by e-DRS all
documents and correspondence will
be dealt with electronically.
We will only issue warning of
cancellation letters to conveyancers if
an email address is inserted.
7
This application is sent to Land Registry by
Key number (if applicable):
Name:
Address or UK DX box number:
Email address:
Reference:
Phone no:
Fax no:
Each applicant may give up to three
addresses for service, one of which
must be a postal address whether or
not in the UK (including the postcode,
if any). The others can be any
combination of a postal address, a UK
DX box number or an electronic
address.
8
Address(es) for service of each applicant as new beneficiary. The
address(es) will be entered in the register and used for
correspondence and the service of notice:
Give date.
Give full name of beneficiary as
entered in the register.
There is provision in panel 13 for the
existing registered beneficiary to
consent to the application.
9
This application relates to the unilateral notice registered on
in favour of:
Place 'X' in the appropriate box.
10
The applicant as new beneficiary applies to be entered in the
register
in place of
in addition to
the existing registered beneficiary
A conveyancer does not have to
enclose documents evidencing the
applicant’s interest; they can, instead,
include the following certificate here:
“I am a conveyancer and I certify that I
hold documentary evidence of the
applicant’s title to the interest
protected by the unilateral notice”.
11
Give details of how the applicant has become entitled to the
interest protected by the notice (for example, as the result of a
transfer, statutory vesting etc.):
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.
12
Signature of applicant
or their conveyancer:
Date:
If applicable.
Place 'X' in the appropriate box.
13
Consent
I/We, the existing registered beneficiary, hereby consent to the
applicant being registered as beneficiary of the unilateral notice
referred to in panel 9.
in place of [me] [us]
in addition to [me] [us]
Print full name
1.
2.
3.
4.
Signatures
1.
2.
3.
4.
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) 05/18
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