Any parts of the form that are not typed should be completed in black ink and in block capitals.
Please complete and lodge this form in duplicate.
If the application is a first registration application and you supply the original and a certified copy of a statutory
declaration, stamp duty land tax certificate, subsisting lease, subsisting charge or the latest document of title
(for example any conveyance to the applicant) we will return the original; if a certified copy is not supplied, we
may retain the original document and it may be destroyed.
If the application is not a first registration then 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.
For information on how HM Land Registry processes your personal information, see our Personal Information
Charter.
1
Property address including postcode (if any):
2
Documents lodged with this form
The first column is for Land Registry use only. If Land Registry places an asterisk ‘*’ in this
column, it shows that we have kept that document.
Please number the documents in sequence; copies should also be numbered and listed as
separate documents.
You need not list the names on land charges searches. Simply enter the search number.
Land
Registry
use only
Item
no
Date
Parties
Land
Registry
use only
Item
no
Date
Parties
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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