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:
Currently no fee is payable for
withdrawing a restriction.
4
Application and fee
Application
Fee paid (£)
Withdrawal of restriction
Fee payment method
cheque made payable to 'Land Registry'
direct debit, under an agreement with Land Registry
Provide the full name(s) of the
person(s) applying to withdraw a
restriction. 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.
5
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.
6
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:
List the documents lodged with 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.
7
Documents lodged with this form:
Insert date and, if applicable, the
name(s) of person(s) named in the
restriction.
Place 'X' in the appropriate box and
complete as necessary.
Give a brief description of the part
affected, for example 'edged red on
the attached plan'.
Insert date of charge and name of
the proprietor of the charge.
8
Application
The applicant applies to withdraw the restriction registered on
in favour of
against the title number(s) listed in panel 2. The application relates
to
the registered estate
the part(s) of the registered estate as shown:
the registered charge dated in favour of:
9
The applicant has an interest in the restriction and applies for the
restriction to be withdrawn
You must place 'X' in only one box
in this panel.
If you are a conveyancer the
certificate is sufficient to comply with
HM Land Registry’s requirements. If
no conveyancer is acting, you must
enclose the required consents with
this application. HM Land Registry
may destroy documents after
scanning.
Panel 12 must be completed or a
separate consent enclosed.
The registrar may call for additional
consents, if it appears to the
registrar that other persons have an
interest in the restriction, and no one
is specified in the restriction as a
person who must consent to a
disposition, give a certificate or
receive notice.
10
The applicant is entitled to apply for the withdrawal of the restriction
because:
(A) The applicant is the only person interested in or specified
in the restriction
The applicant believes that the applicant is the only person
with an interest in the restriction.
The applicant is specified in the restriction as the person(s)
who must consent to a disposition, give a certificate or receive
notice.
(B) The application is made with all required consents
The required consents accompany this application.
I am the applicant's conveyancer and I certify that I hold all
required consents.
The required consents are the consent of every person specified in
the restriction as a person who must consent to a disposition, give
a certificate or receive notice, or, if there is no such person, the
consent of all persons known to the applicant to have an interest in
the restriction.
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.
11
Signature of applicant
or their conveyancer:
Date:
Print full name.
If the restriction requires a specified
person’s consent or certificate, or
notice to be served on a specified
person, that person’s consent must
accompany this application. In all
other cases, any person having an
interest in the restriction must
consent to the withdrawal and state
the nature of their interest.
Print full name.
Print full name.
12
Consent
Name:
Signature:
Interest:
Name:
Signature:
Interest:
Name:
Signature:
Interest:
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signature
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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