This panel must always be
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 application is sent to Land Registry by
Key number (if applicable):
Address or UK DX box number:
Place 'X' in one box only.
For a search of a registered title enter
a date falling within the definition of
‘search from date’ in rule 131 of the
Land Registration Rules 2003. If the
date entered is not such a date the
application may be rejected.
Application and search from date
I apply for a search of the individual register of a registered
title to ascertain whether any adverse entry has been made
in the register or day list since
I apply for a search in relation to a pending application for
first registration to ascertain whether any adverse entry has
been made in the day list since the date of the pending first
Provide the full name(s) of each
purchaser or lessee or chargee.
Place 'X' in the appropriate box.
Reason for application
I certify that the applicant intends to
take a Lease
take a registered Charge
If a conveyancer is acting for the
applicant, that conveyancer must
sign. If no conveyancer is acting, the
applicant (if more than one person
then each) 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.
© Crown copyright (ref: LR/HO) 05/18
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