ESL
Form 003

Lodging Party

Box Number

EXPIRY / TERMINATION BY RE-ENTRY OF A 
SUBLEASE / HEADLEASE OR UNDERLEASE

PRIVACY COLLECTION STATEMENT (PRIVACY ACT 1988 (C’WLTH)) OVERLEAF

1. LAND
Vol:Fol	District/Division	Section	Block	Unit	Instrument No/
Associated Dealing No		
     	     	     	     	     	     		

2. LESSOR
Full name (Surname last)
     

3. LESSEE
Full name (Surname last)
     

4. MODE OF TERMINATION
Effluxion of time, re-entry etc
     

5. CONSENTING PARTY/PARTIES
I / We consent to the following:
     

6. DATE
     	

I hereby apply to note the termination of the lease as described in Item 1.

7. EXECUTION – to be used for termination by re-entry
Signed by the lessor/s

Signature of the lessor/s		Full Name of witness

Signed in my presence

Signature of witness	

Signed by the consenting party/parties

Signature of the consenting party/parties		Full Name of witness

Signed in my presence

Signature of witness	

8. STATUTORY DECLARATION

I,       Of      

Do solemnly and sincerely declare that the premises were peaceably and lawfully recovered.  The requisite time has elapsed between the date of the breach and the date of re-entry.  That clause       was breached.  That no court action has been taken against the lessor in respect of the breach.  And I make this solemn declaration by virtue of the Statutory Declarations Act 1959, and subject to the penalties provided by that Act for the making of false declarations, conscientiously believing the statements contain in this declaration to be true in every particular.

Declared at …………………………………………………………….on 

the                          day of …………………………………………..    

Signature of Applicant		Full name of witness

Signed in my presence

Signature of witness                                                       Qualification of witness	

9. OFFICE USE ONLY
Lodged by	 	Certificates Lodged		
Data Entered by		Attachments Lodged		
Examined by				
Registered by		Registration Date		
PRIVACY STATEMENT

S.43 of the Land Titles Act 1925 (LTA) authorises the Registrar-General to collect the information required by this form for the establishment and maintenance of the Land Titles Register.  S.65-67 LTA requires that the Register be made available to any person for search, upon payment of a fee. The information is regularly provided to various ACT Government agencies, including the ACT Department of Urban Services, ACT Planning and Land Authority (ACTPLA), ACT Treasury, Canberra Connect and ActewAGL for conveyancing, municipal account, administrative, statistical and valuation purposes.  ACTPLA and agencies within the ACT Department of Urban Services may also use the information supplied to prepare and sell property sales reports to commercial organisations concerned with the development, sale or marketing of land.  	
SCHEDULE OF NOTES
1.	This form is to be used only for the expiry or termination of a lease by re-entry.
2.	The Registrar-General may upon being satisfied that the term of a lease has expired, note the expiration in the register.
3.	The existence on the Register of a prior lease whose term has expired, will not be an impediment to the entry of a fresh lease of the same area.  
4.	It is Land Titles practice to note the expiry of a lease in the Register, without the necessity of an application.  Any registered mortgage, underlease etc will fall upon the expiry of a registered sublease.  This is achieved by a Registrar-General’s dealing.
5.	Documents must be typed, or completed in black ink or biro.
6.	Alterations to information entered on the form should be made by crossing out (not erasing or obliterating by painting over) and should be initialled by all parties.
7.	If there is insufficient space in any panel use an annexure sheet.
8.	Volume and Folio references must be given.
9.	Provide full names of the lessee/s and lessor/s.
10.	Consent by parties, usually the mortgagee who consents.
11.	Execution by
•	A Natural Person – should be witnessed by an adult person who is not a party to the document.
•	Attorney – if this document is executed by an Attorney pursuant to a registered power of attorney, it must set out the full name of the attorney and the form of execution must indicate the source of his/her authority eg. “AB by his/her attorney XY pursuant to Power of Attorney ACT Registration No…… of which he/she has no notice of revocation”.
•	Corporation – Section 127 of the Corporations Act provides that a company may validly execute a document with or without using a Common Seal.
NB	The normal witnessing provisions in the Land Titles Act 1925 do not apply to execution by a corporation as above, but do apply to execution by the attorney of a corporation.