Lodging Party

Box Number

CT
Form 011

APPLICATION FOR NEW CERTIFICATE 
OF TITLE
(Replacement - Lost)

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

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

2. FULL NAME/S AND ADDRESS/ES OF APPLICANT/S
     		

3. CAPACITY OF APPLICANT (Delete if not applicable)

Registered Proprietor / Legal Practitioner / Executor / Mortgagee in Mortgage No       

Other, please state       	

4. NAME AND ADDRESS OF REGISTERED PROPRIETOR (Complete where Applicant Is NOT a registered proprietor)
     	

5. CONSENT (All mortgagees/encumbrancees to consent – registered proprietor to consent and state if NOT applicant)

I consent hereto and state that the registered proprietor is not presently an undischarged bankrupt or insolvent, and has not assigned the estate for the benefit of 
creditors and is not subject to the Confiscation of Criminal Assets Act 2003 . 

Signature of Person and Capacity Under Which Consenting
(eg. Registered mortgagee)		Signed in my presence

Signature of witness                                                      

Full name of witness	

Signature of Person and Capacity Under Which Consenting
(eg. Registered mortgagee)		Signed in my presence

Signature of witness                                                      

Full name of witness	

	

6. DATE
     	

I apply pursuant to section 62 of the Land Titles Act 1925  for the issue of a new Certificate of Title. The grant/current edition of the Certificate of Title described in Item 1 has been lost, mislaid or destroyed.  The Certificate of Title in Item 1 is subject to any mortgages, encumbrances and other instruments affecting the land, including any created by dealings lodged prior to this application.  In support of this application, I lodge herewith the following documents:

1.	Statutory declaration by me stating details of the loss of the grant/certificate of title; whether or not the registered proprietor resides at the property; that the grant or certificate of title is not held by any person as security for a loan or any other purpose whatsoever; and that the registered proprietor is not presently an undischarged bankrupt or insolvent, and has not assigned the estate for the benefit of creditors and is not subject to the Confiscation of Criminal Assets Act 2003.

2.	Statutory declaration by mortgagee or legal practitioner for the mortgagee as to the facts of the loss.

3.      A current A.C.T. Government General Land Rates Notice relating to the property.

7. EXECUTION
Signed by the applicant/s

Signature of applicant/s		Signed in my presence

Signature of witness                                                      

Full name of witness	

8. 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.	In the case of a lost grant or certificate of title, S.62(1) provides that the registered proprietor of land may apply to the Registrar-General for the issue of a replacement Certificate of Title.  In practice, this will be extended to a legal practitioner for the registered proprietor and to a registered mortgagee on title.  If the registered proprietor is deceased, the person entitled to be registered, or his/her legal practitioner, may apply.  Applications made under a Power of Attorney will be checked against the original Power of Attorney held in this office. An application made by one of several joint tenants or tenants in common must bear the consent of all other proprietors (except in the case of separate Certificates of Title.

Proof of the applicant’s identity and any further proof of ownership will be required.  In certain circumstances, holders of a Land Titles ‘Dial-A-Search’ account may be exempt from this requirement.  Acceptable forms of ID/proof include a combination of driver’s licence; passport; Medicare Card; pensioner card; rates notice; and Tax File Number.  The loss of a grant or Certificate of Title may be required to be reported to the Police. In such a case, the Registrar-General’s Office will contact the Police to confirm that the loss has been reported.  For security reasons replacement certificates cannot be posted to applicants.
2.	Documents must be typed or completed preferably 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 the parties.  
4.	Volume and Folio references must be given.  
5.	Provide the full name/s of the applicant and address/es of the applicant/s.
6.	Provide the capacity under which the applicant is applying for the replacement Certificate of Title.
7.	Provide the full name and address of the registered proprietor, where the applicant is not the registered proprietor.
8.	Where the applicant is not the registered proprietor, the applicant must obtain the consent of all mortgagees/encumbrances and/or proprietor.
9.	Execution in accordance with the Land Titles Act 1925.