Lodging Party

Box Number

ACL
Form 031

APPLICATION TO REGISTER A
CROWN LEASE

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

I hereby apply for the registration of the attached Crown Lease:  Please note only ONE Crown Lease per application.	

IS THIS LEASE GRANTED AS CONSIDERATION FOR THE SURRENDER OF AN EXISTING LEASE/S?         Yes          No

1. LIST ALL PARCELS IN NEW LEASE
District/Division	Section	Block			
     	     	     			
     	     	     			
     	     	     			

2. LESSEE/S
Full name (Surname Last)

     

	

3. LIST ALL PARCELS IN SURRENDERED LEASE/S
Vol:Fol	District/Division	Section	Block				
     	     	     	     				
     	     	     	     				
     	     	     	     				
     	     	     	     				

4. DATE
     

5. OFFICE USE ONLY
Lodged by	 	Certificates Lodged		
Data Entered by		Attachments Lodged		
Examined by		Deposited Plan Noted		
Requisitions		Volume : Folio		
Registered by		Registration Date		
	
6. OFFICE USE ONLY
CROWN LEASE WITHDRAWN		

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 to apply to register a new Crown Lease.
2.	Documents must be typed, or completed in black ink or biro.
3.	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.
4.	If there is insufficient space in any panel, please use an annexure sheet.
5.	Volume and Folio references must be given. 
6.	Provide full name/s of the lessee/s.
7.	Acknowledgement and imprint of the ACT Revenue Office.