Is this application for a first transfer?
	•	YES

•	NO	
If yes please use the consent to first transfer form 1

Complete this form	

Lease details please print

Block	

Section	
	Suburb		

Street number	

Street name	

Postcode	

Applicant details please print

Surname	
		First name		
		
Company name	

Position held in company			Australian Company/Business Number (ACN/ABN)		
		
Postal address	

Suburb	
		State			Postcode		
				
Phone number business hours			Mobile		
		
Email address

 		

Lessee (property owners) details please print

First lessee’s details

Surname	
		First name		
		
Company name	

Position held in company			Australian Company/Business Number (ACN/ABN)		
		
Postal address	

Suburb	
		State			Postcode		
				
Phone number business hours			Mobile		
		
Email address	

Second lessee’s details

Surname	
		First name		
		
Company name	

Position held in company			Australian Company/Business Number (ACN/ABN)		
		
Postal address	

Suburb	
		State			Postcode		
				
Phone number business hours			Mobile		
		
Email address	

All lessees must sign authorising the lodgement of this application. In doing so the lessee gives authority to the applicant to negotiate any dealings in relation to the application through to its determination. If there are more than two lessees please ensure that the details and authorisation are attached to the application.

Buyers details please print

First buyers details

Surname	
		First name		
		
Company name	

Position held in company			Australian Company/Business Number (ACN/ABN)		
		
Postal address	

Suburb	
		State			Postcode		
				
Phone number business hours			Mobile		
		
Email address	

Second buyers details

Surname	
		First name		
		
Company name	

Position held in company			Australian Company/Business Number (ACN/ABN)		
		
Postal address	

Suburb	
		State			Postcode		
				
Phone number business hours			Mobile		
		
Email address	

All buyers must sign authorising the lodgement of this application. In doing so the buyer gives authority to the applicant to negotiate any dealings in relation to the application through to its determination. If there are more than two buyers please ensure that the details and authorisation are attached to the application.

Please note:  To help you provide information a table titled “Documentation requirements – definitions and checklist” can be found at the end of this form. 

Statutory declaration from the seller(s)

Is a statutory declaration from the seller(s) for the land specified in this application attached?	•	NO
•	YES
	
Evidence supporting the statutory declaration 

Is the evidence supporting the seller(s) inability to proceed with the purchase/construction
for the land specified in this application attached?	•	NO
•	YES
	
Building contract if entered into

Is a copy of the building contract for the land specified in this application attached?	•	NO
•	YES
	
Statutory declaration from the buyer(s)	

Is a statutory declaration from the buyer(s) for the land specified in this application attached?	•	NO
•	YES
	
Evidence of financial capacity

Is all the evidence for financial capacity from the buyer to purchase the land and construct
a dwelling* on the block for the land specified in this application attached?	•	NO
•	YES
	
Building covenants

Is there at least a minimum of six months left on the commencement covenant contained
in the Crown lease for the land specified in this application attached?
	•	NO
•	YES
	
Transfer form

Is the transfer form for the land specified in this application attached?	•	NO
•	YES
	
Unregistered Crown lease / lessee’s name

Has a letter been provided advising that there has been an on-sale of all documents 
connected with the registration of the Crown lease and/or advising that the lessee’s name 
for the land specified in this application will be registered at the Land Titles Office at the time
of settlement?
	•	NO
•	YES
	
Conflict of interest declaration

Does the applicant, lessee or buyer have any association with ACT Planning and Land Authority staff?          	•	NO
•	YES
	
If YES - please provide details:	

NOTE: There are penalties for deliberately giving false and misleading information.  The ACT Planning and Land Authority or Planning Minister may revoke an approval if satisfied that the approval was obtained by fraud or misrepresentation.

* - dwelling does not exclude other developments of a non residential nature.

Other requirements

Lodgment and payment

A valid application for consent to transfer comprises a completed application for consent to transfer form accompanied by all of the required information or documents necessary for the application to be considered for approval.

Once an application for consent to transfer is received the documentation will be checked to ensure it meets the standard for lodgement. If the documentation provided is acceptable you will receive written confirmation that the application is ready for lodgement and a request for the payment of application fees. An application for consent to transfer is not lodged until all fees are paid.

If the documentation is not acceptable for lodgement, you will receive written advice detailing the additional information required and/or any issues with your application.  Once these documents are provided, the ACT Planning and Land Authority will recommence the documentation check and fee payment process outlined above.

Documents 

All required documents must be provided in hard copy.

Applicant, lessee and buyer declaration

I/we the undersigned, hereby apply for approval for consent to transfer on the land specified in this application.

I/we declare that this application is accompanied by all of the required information or documents for it to be considered for approval.

I/we understand that the information submitted with this application form will undergo a documentation check prior to the payment of fees and formal lodgement of the application. Further information may be required before acceptance of the application for consent to transfer by ACTPLA.

I/we understand that this application will be considered lodged once the relevant application fees have been paid.

I/we understand that the documentation provided will be considered to be the relevant documentation associated with this application.

I/we the undersigned appoint the applicant whose signature appears below to act on my/our behalf in relation to this application for consent to transfer. This authorises the applicant to pay all application fees and liaise with the ACT Planning and Land Authority when required, alter, amend or provide further information as necessary and receive any communications relating to this application for consent to transfer.

I/we declare that all information given on this form and its attachments is true and complete.

If signing on behalf of a company or organisation:

I/we the undersigned, declare I/we have the appropriate delegation or authority to sign on behalf of the company or organisation.

Applicant signature (s)	
	Date		
				
First lessee’s signature	
	Date		
				
Second lessee’s signature	
	Date		
				
First buyer’s signature 

	Date		
				
Second buyer’s signature 

	Date		

Please make sure you complete the documentation requirements checklist at the end of this form

Documentation requirements – consent to transfer

Key:

•	Required
  w   Required if relevant		
Seller(s) statutory declaration
(Required if not applying under s298(2)(b)(iv))
	w	
Evidence supporting the statutory declaration from the seller(s)
(Required if not applying under s298(2)(b)(iv))
	w	
Building contract
(Required if applying under s298(2)(b)(iv))
	w	
Buyer(s) statutory declaration
	•		
Evidence of financial capacity from the buyer(s)
	•		
Building covenants
(Provide a copy of the extension of time letter from ACTPLA)
	w 	
Transfer form
	•		
Unregistered Crown lease / lessee’s name
(Required if Crown lease and/or the lessee’s name are not registered at the Land Titles Office)
		w 	

Documentation requirements – definitions and checklist

Submission requirement		Required information	Office use	
Statutory declaration from the seller(s)
(example attached)
	•	Details of the seller(s) as registered on the Crown lease being transferred
•	Details of the land being transferred
•	Reasons why the land is being transferred
	
•	Supplied 
•	Not required
	
Evidence supporting the statutory declaration
	•	Evidence supporting the reasons stated in the seller(s) 
statutory declaration as to why the land is being transferred,
e.g. declined loan
	
•	Supplied
•	Not required
	
Building contract	Copy of the relevant pages that contain the following information:
•	details of the land being transferred
•	details of the buyer(s)
•	details of the builder (must be the same name as registered on the Crown lease being transferred)
•	signatures of the buyer(s)
•	signature of the builder
•	the cost of the building work to construct the dwelling.
	
•	Supplied
•	Not required
	
Statutory declaration from the buyer
(example attached)	•	Details of the buyer(s)
•	Details of the land being transferred
•	A statement confirming the buyer(s) financial capacity to purchase the land and construct a dwelling
•	Agreement from the buyer(s) that they will comply with the development covenants contained within the Crown lease
	
•	Supplied
•	Not required

Submission requirement		Required information	Office use	
Evidence of financial capacity

	Provide one or more of the following documents (or like documents):
•	loan approval(s) from a financial institution connected to the buyer(s) AND the land being transferred
•	current bank statements in the buyer(s) name (not less than 1 month old)
•	current line of credit statement in the buyer(s) name;
•	deposit copies of trust accounts or receipts connected to the buyer
•	gifted money – statutory declaration from person gifting money AND evidence that that person has the money (eg. recent bank statement in persons name)
•	internet bank statements are not accepted as the account holders details are not on the printout.
	
•	Supplied
•	Not required

Building covenants	If less then 6 months left on commencement covenant:
Provide one or more of the following:
•	evidence of extension of time approved by Land and Lease Regulation Unit and relevant fees paid to ACTPLA
•	a letter from the buyer(s) stating they are aware of the date the building is required to start (must state date) and if the building does not commence by that date, then they are responsible for making an application to ACTPLA and paying for an extension of time to extend the development covenants
•	if construction on the building has already commenced, the signed inspection certificate issued by a registered certifier (e.g. footings inspection or first drainage test).

Please note: The completion covenant should allow enough time to complete the construction of the dwelling.  If not completed by the date stated in the Crown lease or any extension granted, an extension of time from ACTPLA will be required prior to a compliance certificate being issued.
	
•	Supplied
•	Not required
	
Transfer form	Available from the Office of Regulatory Services website at www.ors.act.gov.au/landtitles/index.html:
•	block, section and suburb
•	volume and folio Numbers (where Crown Lease is registered)
•	consideration amount
•	development status
•	seller(s) details as registered on Crown lease
•	buyer(s) details as to appear on Crown lease
•	seller(s) signature and witness’ signature
•	buyer(s) signature and witness’ signature.
	
•	Supplied
•	Not required
	
Unregistered Crown lease / lessee’s name	If the Crown lease and/or the lessee’s name are not registered at the Land Titles, the following information is required:
•	a letter from the applicant advising that an on-sale involving the Crown lease and/or the Lessee’s name will occur at the time of settlement for this transfer at the Land Titles Office; and
•	copy(s) of the front page(s) of each Contract of Sale between the Lessee and buyer.
	
•	Supplied
•	Not required
	
Contact details:	Privacy notice
ACT Planning and Land Authority	The personal information on this form is being collected to enable 
Customer Service Centre	processing of your application.  Collection of personal information is 
GPO Box 1908, Canberra City 2601	authorised by Chapters 7, 8 and 9 of the Planning and Development
16 Challis Street, Dickson ACT 2602	Act 2007.  The information that you provide may be disclosed to  
Business Hours: 8.30am to 4.30pm weekdays (excluding Public Holidays)	Government Agencies such as the ACT Revenue Office and the
Phone: (02) 6207 1923	Registrar-General’s Office.
Fax: (02) 6207 1925
TTY: (02) 6207 2622
Email: actpla.customer.services@act.gov.au	
Website: www.actpla.act.gov.au

Commonwealth of Australia
STATUTORY DECLARATION
Statutory Declarations Act 1959

1	Insert the name, address and occupation of person making the declaration
	
I/We,  
of 
make the following declaration under the Statutory Declarations Act 1959:	
2	Set out matter declared to in numbered paragraphs	2
1.	IWe am/are the Lessee/seller of:

	Block
	Section
	Division 

	and I/we am/are proposing to transfer the Crown lease pursuant to Section 298 of the Planning and Development Act 2007.

2.	I/We are unable to comply with the building and development provision contained in the 	Crown lease due to 

    

3.	Attached is the evidence supporting the reasons for my/our inability to comply with the building and development provision contained in the Crown lease.  

I/We understand that a person who intentionally makes a false statement in a statutory declaration is guilty of an offence under section 11 of the Statutory Declarations Act 1959, and I/we believe that the statements in this declaration are true in every particular.

3	Signature of person making the declaration	3

4	Place
5	Day
6	Month and year	Declared at 4                                            on 5                             of 6  

Before me,
	
7	Signature of person before whom the declaration is made (see over)
	7

8	Full name, qualification and address of person before whom the declaration is made (in printed letters)	8

	
Note 1   A person who intentionally makes a false statement in a statutory declaration is guilty of an offence, the punishment for which is imprisonment for a term of 4 years — see section 11 of the Statutory Declarations Act 1959.
Note 2   Chapter 2 of the Criminal Code applies to all offences against the Statutory Declarations Act 1959 — see section 5A of the Statutory Declarations Act 1959.

A statutory declaration under the Statutory Declarations Act 1959 may be made before–
(1) a person who is currently licensed or registered under a law to practise in one of the following occupations:
Chiropractor		Dentist			Legal practitioner
Medical practitioner	Nurse			Optometrist
Patent attorney		Pharmacist			Physiotherapist
Psychologist		Trade marks attorney		Veterinary surgeon
(2) a person who is enrolled on the roll of the Supreme Court of a State or Territory, or the High Court of Australia, as a legal practitioner (however described); or
(3) a person who is in the following list:
Agent of the Australian Postal Corporation who is in charge of an office supplying postal services to the public
Australian Consular Officer or Australian Diplomatic Officer (within the meaning of the Consular Fees Act 1955)
Bailiff
Bank officer with 5 or more continuous years of service
Building society officer with 5 or more years of continuous service
Chief executive officer of a Commonwealth court
Clerk of a court
Commissioner for Affidavits
Commissioner for Declarations
Credit union officer with 5 or more years of continuous service
Employee of the Australian Trade Commission who is:
(a) in a country or place outside Australia; and
(b) authorised under paragraph 3 (d) of the Consular Fees Act 1955; and
(c) exercising his or her function in that place
Employee of the Commonwealth who is:
(a) in a country or place outside Australia; and
(b) authorised under paragraph 3 (c) of the Consular Fees Act 1955; and
(c) exercising his or her function in that place
Fellow of the National Tax Accountants’ Association
Finance company officer with 5 or more years of continuous service
Holder of a statutory office not specified in another item in this list
Judge of a court
Justice of the Peace
Magistrate
Marriage celebrant registered under Subdivision C of Division 1 of Part IV of the Marriage Act 1961
Master of a court
Member of Chartered Secretaries Australia
Member of Engineers Australia, other than at the grade of student
Member of the Association of Taxation and Management Accountants
Member of the Australasian Institute of Mining and Metallurgy
Member of the Australian Defence Force who is:
(a) an officer; or
(b) a non-commissioned officer within the meaning of the Defence Force Discipline Act 1982 with 5 or more years of continuous service; or
(c) a warrant officer within the meaning of that Act
Member of the Institute of Chartered Accountants in Australia, the Australian Society of Certified Practising Accountants or the National Institute of Accountants
Member of:
(a) the Parliament of the Commonwealth; or
(b) the Parliament of a State; or
(c) a Territory legislature; or
(d) a local government authority of a State or Territory
Minister of religion registered under Subdivision A of Division 1 of Part IV of the Marriage Act 1961
Notary public
Permanent employee of the Australian Postal Corporation with 5 or more years of continuous service who is employed in an office supplying postal services to the public
Permanent employee of:
(a) the Commonwealth or a Commonwealth authority; or
(b) a State or Territory or a State or Territory authority; or
(c) a local government authority;
with 5 or more years of continuous service who is not specified in another item in this list
Person before whom a statutory declaration may be made under the law of the State or Territory in which the declaration is made
Police officer
Registrar, or Deputy Registrar, of a court
Senior Executive Service employee of:
(a) the Commonwealth or a Commonwealth authority; or
(b) a State or Territory or a State or Territory authority
Sheriff
Sheriff’s officer
Teacher employed on a full-time basis at a school or tertiary education institution

Commonwealth of Australia
STATUTORY DECLARATION
Statutory Declarations Act 1959

1	Insert the name, address and occupation of person making the declaration
	
I/We,  
of 
make the following declaration under the Statutory Declarations Act 1959:	
2	Set out matter declared to in numbered paragraphs	2
4.	IWe am/are the proposed transferee/buyer of:

	Block
	Section
	Division            

5.	I/We confirm that I/we have the financial ability to both purchase the land and complete construction on the land.       

6.	Attached is the financial evidence supporting my/our ability to both purchase and complete construction on the land.

7.	I/We undertake to comply with the building and development covenants contained in the Crown lease.

I/We understand that a person who intentionally makes a false statement in a statutory declaration is guilty of an offence under section 11 of the Statutory Declarations Act 1959, and I/we believe that the statements in this declaration are true in every particular.  
	
3	Signature of person making the declaration	3

4	Place
5	Day
6	Month and year	Declared at 4                                            on 5                             of 6  

Before me,
	
7	Signature of person before whom the declaration is made (see over)
	7

8	Full name, qualification and address of person before whom the declaration is made (in printed letters)	8

	
Note 1   A person who intentionally makes a false statement in a statutory declaration is guilty of an offence, the punishment for which is imprisonment for a term of 4 years — see section 11 of the Statutory Declarations Act 1959.
Note 2   Chapter 2 of the Criminal Code applies to all offences against the Statutory Declarations Act 1959 — see section 5A of the Statutory Declarations Act 1959.

A statutory declaration under the Statutory Declarations Act 1959 may be made before–
(1) a person who is currently licensed or registered under a law to practise in one of the following occupations:
Chiropractor		Dentist			Legal practitioner
Medical practitioner	Nurse			Optometrist
Patent attorney		Pharmacist			Physiotherapist
Psychologist		Trade marks attorney		Veterinary surgeon
(2) a person who is enrolled on the roll of the Supreme Court of a State or Territory, or the High Court of Australia, as a legal practitioner (however described); or
(3) a person who is in the following list:
Agent of the Australian Postal Corporation who is in charge of an office supplying postal services to the public
Australian Consular Officer or Australian Diplomatic Officer (within the meaning of the Consular Fees Act 1955)
Bailiff
Bank officer with 5 or more continuous years of service
Building society officer with 5 or more years of continuous service
Chief executive officer of a Commonwealth court
Clerk of a court
Commissioner for Affidavits
Commissioner for Declarations
Credit union officer with 5 or more years of continuous service
Employee of the Australian Trade Commission who is:
(a) in a country or place outside Australia; and
(b) authorised under paragraph 3 (d) of the Consular Fees Act 1955; and
(c) exercising his or her function in that place
Employee of the Commonwealth who is:
(a) in a country or place outside Australia; and
(b) authorised under paragraph 3 (c) of the Consular Fees Act 1955; and
(c) exercising his or her function in that place
Fellow of the National Tax Accountants’ Association
Finance company officer with 5 or more years of continuous service
Holder of a statutory office not specified in another item in this list
Judge of a court
Justice of the Peace
Magistrate
Marriage celebrant registered under Subdivision C of Division 1 of Part IV of the Marriage Act 1961
Master of a court
Member of Chartered Secretaries Australia
Member of Engineers Australia, other than at the grade of student
Member of the Association of Taxation and Management Accountants
Member of the Australasian Institute of Mining and Metallurgy
Member of the Australian Defence Force who is:
(a) an officer; or
(b) a non-commissioned officer within the meaning of the Defence Force Discipline Act 1982 with 5 or more years of continuous service; or
(c) a warrant officer within the meaning of that Act
Member of the Institute of Chartered Accountants in Australia, the Australian Society of Certified Practising Accountants or the National Institute of Accountants
Member of:
(a) the Parliament of the Commonwealth; or
(b) the Parliament of a State; or
(c) a Territory legislature; or
(d) a local government authority of a State or Territory
Minister of religion registered under Subdivision A of Division 1 of Part IV of the Marriage Act 1961
Notary public
Permanent employee of the Australian Postal Corporation with 5 or more years of continuous service who is employed in an office supplying postal services to the public
Permanent employee of:
(a) the Commonwealth or a Commonwealth authority; or
(b) a State or Territory or a State or Territory authority; or
(c) a local government authority;
with 5 or more years of continuous service who is not specified in another item in this list
Person before whom a statutory declaration may be made under the law of the State or Territory in which the declaration is made
Police officer
Registrar, or Deputy Registrar, of a court
Senior Executive Service employee of:
(a) the Commonwealth or a Commonwealth authority; or
(b) a State or Territory or a State or Territory authority
Sheriff
Sheriff’s officer
Teacher employed on a full-time basis at a school or tertiary education institution