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
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
For information on how HM Land Registry processes your personal
information, see our Personal Information Charter.
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.
Local authority serving the property:
Title number(s) of property:
Insert address including postcode (if any)
or other description of the property, for
example ‘land adjoining 2 Acacia
Place 'X' in the appropriate box.
Give a brief description of the part
affected, for example ‘edged red on the
plan to the statutory declaration dated
……….’. The statutory declaration or
statement of truth must exhibit a plan
identifying clearly the extent of the part,
unless one of the exceptions in rule 188
of the Land Registration Rules 2003
The application relates to
the whole of the title(s)
part of the title(s) as shown:
To find out more about our fees visit
Place 'X' in the appropriate box.
The fee will be charged to the account
specified in panel 8.
Application and fee
Fee paid (£)
Registration of a person in adverse
Fee payment method
cheque made payable to 'Land Registry'
direct debit, under an agreement with Land Registry
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:
1. Statutory declaration/
Statement of truth
Provide the full name(s) of the person(s)
applying to be registered. 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.
Also, for an overseas company, unless
an arrangement with HM Land Registry
exists, lodge either a certificate in Form 7
in Schedule 3 to the Land Registration
Rules 2003 or a certified copy of the
constitution in English or Welsh, or other
evidence permitted by rule 183 of the
Land Registration Rules 2003.
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
Each proprietor 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.
Applicant's intended address(es) for service (including
postcode) for entry in the register:
This panel must always be completed.
A key number is only available to
professional customers, such as
If you are paying by direct debit, this will
be the account charged.
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
We will only issue warning of cancellation
letters to conveyancers if an email
address is inserted.
This application is sent to Land Registry by
Key number (if applicable):
Address or UK DX box number:
Email address:
Phone no:
Fax no:
Where there is more than one applicant,
place 'X' in the appropriate box.
Complete as necessary.
The registrar will enter a Form A
restriction in the register unless:
an ‘X’ is placed:
in the first box, or
in the third box and the details of
the trust or of the trust
instrument show that the
applicants are to hold the
property on trust for themselves
alone as joint tenants, or
it is clear from completion of a form
JO lodged with this application that
the applicants are to hold the
property on trust for themselves
alone as joint tenants.
Please refer to Joint property ownership
and practice guide 24: private trusts of
land for further guidance. These are both
available on the GOV.UK website.
Declaration of trust. The applicant is more than one person and
they are to hold the property on trust for themselves as joint
they are to hold the property on trust for themselves as
tenants in common in equal shares
they are to hold the property on trust:
Place 'X' in the appropriate box.
This application is made under
Paragraph 1 of Schedule 6 to the Land Registration Act
Paragraph 6(1) of Schedule 6 to the Land Registration Act
Place ‘X’ in the appropriate box or boxes
if the applicant intends to rely on one or
more than one of these conditions should
a counter notice under paragraph 3 of
Schedule 6 be lodged in response to the
If applying under Paragraph 1 of Schedule 6 to the Land
Registration Act 2002 confirm which, if any, of the following
conditions you intend to rely on
Paragraph 5(2) of Schedule 6
Paragraph 5(3) of Schedule 6
Paragraph 5(4) of Schedule 6
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
or their conveyancer:
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.
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