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 conveyancers.
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 £
Fee paid (£)
To find out more about our fees visit
Search in the index of proprietors'
Place ‘X’ in the appropriate box.
The fee will be charged to the account
specified in panel 3.
Provide the full name(s) of the person(s)
making the application.
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.
Key number (if applicable):
Phone no:
Fax no:
HM Land Registry
PO Box 292
Plymouth PL5 9BY
DX 8249 Plymouth 3
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
Documents lodged with this form:
Enter the full name (in forename
surname order) of the person in
respect of whom the search is to be
made. Only one name per form a
separate form should be used in
respect of any former or alternative
The applicant applies for a search to be made in the index of
proprietors' names in respect of:
Every address that may have been
entered in the register should be
Enter the address of the person named in panel 5:
Place 'X' in the appropriate box.
Enclose evidence of death or a
conveyancer's certificate to that
State reasons.
Entitlement to search
The applicant is
searching against their own name
searching against a company or other corporation aggregate
a personal representative of name searched
a trustee in bankruptcy of name searched
otherwise interested generally within the meaning of rule
11(3) of the Land Registration Rules 2003:
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(s)
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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