Lease/Site Details Please Print

If more than one lease/site, attach the following details for each lease/site

Block	

Section	
	Suburb		
		
District	

Street Number	

Street Name	

Postcode	

Applicant Details Please Print

Surname	
		First Name		
		
Company Name	

Postal Address	

Suburb	
		State			Postcode		
				
Phone Number Business Hours			Mobile	*	
		
EMAIL ADDRESS
	*	

Lessee (Property Owners) Details Please Print

1st 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	*	

2nd 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 for unit title. 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.

* - Optional

Endorsement of Units Plan for Registration

Your approved Units Plan will be held for collection.

Unit Details 

Type of units

	•	Class A		Number of Units   _______________	
	OR
	•	Class B		Number of Units  ________________	

Class A units are defined by reference to the floors, walls and ceilings of the building.
Class B units are unlimited in height except to the extent of any encroachment at, above
or below ground level by another part of the parcel.

The development is

	•	Residential		•	Commercial/Industrial	

	•	UnStaged 		•	Staged (2 unit developments cannot be staged)	

If a staged development, please complete the following stage and costing details

	Stage 1		Unit No.  ________ to _________	

	Stage 2		Unit No.  ________ to _________	

	Stage 3		Unit No.  ________ to _________	

(If more than 3 stages, please provide details separately)

	Cost of total development		$ _______________	

	Cost of outstanding building works		$ _______________	

	Cost of outstanding site works		$ _______________	

The following driveways information is for 2 unit developments only:

Driveways (For works on verge only)

Please advise whether any construction or modification of driveway/s has been undertaken:	
•	Not applicable (declaration required)	•	Construction of additional entrance	
•	Relocation of existing entrance	•	Modification of existing entrance (eg. re-surfaced)	
•	Construction of two separate entrances	•	Other (please specify) ________________________________	

Use of the Land

Is the Use of the land consistent with the current purpose clause contained in the existing Crown lease?	•	YES 	•	NO	

Please specify which Zone in the Territory Plan applies to the 
block specified in this application: 	
		
(Please Note:  The Crown lease of all blocks falling under the Residential and Industrial Zones in the Territory Plan must specify the number of units.)

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

Form 1A – Site Plan

Is a site plan (Form 1A) for the land specified in this application attached?
	•	NO
•	YES	

Form 1 – Surveyors Declaration

Is a surveyor’s declaration (Form 1) for the land specified in this application attached?
	•	NO
•	YES	

Form 2 – Schedule of Unit Entitlements

Is a Schedule of Unit Entitlements (Form 2) for the land specified in this application attached?
	•	NO
•	YES	

Form 3 – Floor Plan

Is a Floor Plan (Form 3) for the land specified in this application attached?
	•	NO
•	YES	

Surveyor’s Checklist

Is a Surveyor’s Checklist for the land specified in this application attached?
	•	NO
•	YES	

Certification of Unit Entitlements by a Member of the Institute of Valuers

Is a Certification of Unit Entitlement by a Member of the Institute of Valuers for the land specified in this application attached?
	•	NO
•	YES	

Unit Title Assessment Report

Is a Unit Title Assessment Report for the land specified in this application attached?
	•	NO
•	YES	

Certificate of Occupancy and Use

Is a Certificate of Occupancy and Use for the land specified in this application attached?
	•	NO
•	YES	

Asset Acceptance Certificate of Operational Acceptance

Is a Certificate of Operational Acceptance from Asset Acceptance for the land specified in this application attached?

NOTE: A Certificate of Operational Acceptance is obtained from the Asset Acceptance Section within the Department of Territory and Municipal Services.	•	NO
•	YES	

ActewAGL Certificate of Operational Acceptance

Is a Certificate of Operational Acceptance from ActewAGL for the land specified in this application attached?

NOTE: A Certificate of Operational Acceptance is obtained from ActewAGL. 	•	NO
•	YES	

Fitness for Unit Title Certificate

Is a Fitness for Unit Title Certificate for the land specified in this application attached?

NOTE: A Fitness for Unit Title Certificate is obtained from an eligible building surveyor. 	•	NO
•	YES	

Encroachment/s – Certification that no encroachment exists

Is a statement attached which confirms that any structure not shown on the site plan or floor plan does not encroach?

NOTE: Certification is obtained from a registered surveyor.	•	NO
•	YES	

Encroachment/s – Certification of encroachment over parcel boundary

Is a statement attached which confirms that any encroachment over the parcel boundary complies with the Unit Titles Act 2001 and has development approval?

NOTE: Certification is obtained from a registered surveyor. 	•	NO
•	YES	

Driveways for Two Unit Developments (For works on verge only)

Is a Verge/Driveway Inspection Certificate for the land specified in this application attached?

NOTE: A Verge/Driveway Inspection Certificate is obtained from the Asset Acceptance Section within the Department of Territory and Municipal Services.	•	NO
•	YES
•	N/A	

Statutory Declaration for Driveways for Two Unit Developments (For works on verge only)

If a Verge/Driveway Inspection Certificate is not applicable, is a declaration stating that the driveway has not been changed since the Compliance Certificate for the original residence was issued      for the land specified in this application attached?

NOTE:  A declaration is required from the Lessee if the existing entrance has not been modified in a two unit development. 	•	NO
•	YES
•	N/A	

Crown Lease

Is the Crown Lease for the land specified in this application registered at the Land Titles Office?
	•	NO
•	YES	

Conflict of Interest Declaration

Does the applicant or lessee 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 Planning and Land Authority or Minister may revoke an approval if satisfied that the approval was obtained by fraud or misrepresentation.

Other Application for Unit Title Requirements

LODGEMENT & PAYMENT

A valid application for unit title comprises a completed application for unit title form accompanied by all of the required information or documents for it to be considered for approval.

Once an application for unit title is received, the documentation will be checked to ensure it meets the standard for lodgment.  If the documentation provided is acceptable, you will receive written confirmation the application is ready for lodgment and a request for the payment of the application fees. An application for unit title is not lodged until full payment of fees is made and receipted by the Authority.

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

DOCUMENTATION AND PLANS

All required documentation must be provided in hard copy.

Applicant and Lessee Declaration

I/we the undersigned, hereby apply for approval for unit title as described 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 prior to the acceptance of the application for unit title by the Authority;

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 understand that further information may be requested after the application for unit title is lodged with the Authority;

I/we hereby authorise ACT Government officers to access the subject property(s) for the purpose of evaluating the proposal;

I/we the undersigned (lessee) appoint the applicant whose signature appears below to act on my/our behalf in relation to this application for unit title. This authorises the applicant to pay all application fees, bonds and securities, liaise with the Authority when required, alter, amend or provide further information as necessary and receive any communications relating to this application for unit title;

I/we declare that all the 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		
				
1st Lessee’s Signature	
	Date		
				
2nd Lessee’s Signature	
	Date		

PLEASE MAKE SURE YOU COMPLETE THE DOCUMENTATION REQUIEMENTS CHECKLIST 
AT THE END OF THIS FORM

DOCUMENTATION REQUIREMENTS FOR UNIT TITLE

Key:

•	Required
 w   Required if relevant
      N/A	2 Residential units	3 or more Residential units	2 or more Commercial/industrial units	Staged development	
Form 1A – Site Plan	•		•		•		•		
Form 1 – Surveyor’s Declaration  	•		•		•		•		
Form 2 – Schedule of Unit Entitlements	•		•		•		•		
Form 3 – Floor Plan	•		•		•		•		
Surveyor’s Checklist	•		•		•		•		
Certificate of Unit Entitlements (valuation) 	•		•		•		•		
Unit Title Assessment Report	•		•		•		•		
Certificate of Occupancy and Use	•		•		•		•		
Asset Acceptance Certificate of Operational Acceptance		•		•		•		
ActewAGL Certificate of Operational Acceptance		•		•		•		
Fitness for Unit Title Certificate	w	w	w	w	
Encroachment/s – Certification that no encroachment exists 	•		•		•		•		
Encroachment/s – Certification of encroachment over parcel boundary
	w	w	w	w	
Verge/Driveway Inspection Certificate	w	      	      	      	
Driveway Statutory Declaration 	w	      	      	      	

DOCUMENTATION REQUIREMENTS – DEFINITIONS & CHECKLIST	
			
Submission Requirement	Required Information	Office Use	

Form 1A – Site Plan	
Preferred Format:
	
B4 film                                                (original plus 2 paper copies to scale)
(Approved Form by Registrar-General under s140 Land Titles Act 1925) 
•	Delineates the Site 
•	States block identifier
•	Notes the location of all buildings and structures with dimensions to block boundaries
•	States class of units
•	States number of units
•	Notes the unit subsidiaries, if any
•	Shows the common property
•	Notes the area of the block
•	Notes the Deposited Plan Number
•	All easements on the land
•	Is drawn to scale
•	Shows the direction of north
•	Prepared and signed by registered Surveyor
	•	Supplied

Form 1 – Surveyors Declaration Form
	
Preferred Format:
	
A4 black and white                             (original plus 2 paper copies to scale)
(Approved Form by Registrar-General under s140 Land Titles Act 1925) 
•	States Block Identifier
•	States Volume and Folio
•	States Deposited Plan Number
•	States Name of Manager/Owners Corporation
•	States Address for Service of Notice
•	Prepared and signed by registered Surveyor
	•	Supplied

Form 2 – Schedule of Unit Entitlements

Preferred Format:
	
A4 black and white                             (original plus 2 paper copies to scale)
(Approved Form by Registrar-General under s140 Land Titles Act 1925) 
•	States block Identifier
•	States number of units
•	States unit entitlement for each unit and aggregate
•	States number of unit subsidiaries and aggregate, if applicable
•	Prepared and signed by registered Surveyor
	•	Supplied

Forms 3 – Floor Plan
	
Preferred Format:
	
B4 film                                                (original plus 2 paper copies to scale)
(Approved Form by Registrar-General under s140 Land Titles Act 1925) 
•	States block identifier
•	Shows a plan of each floor
•	Shows each unit
•	Shows and describes each unit subsidiary, if any
•	Shows the relevant dimensions
•	Identifies common property
•	Is drawn to scale
•	Shows the direction of north
	•	Supplied

Surveyor’s Checklist
	
Preferred Format:
	
A4 black and white                                                                           (original)
•	Prepared and signed by registered Surveyor	•	Supplied

Certification of Unit Entitlements
	
Preferred Format:
	
A4 black and white                                                                           (original)
•	States block identifier
•	States number of units
•	States unit entitlement for each unit and aggregate
•	Prepared and signed by registered Valuer
	•	Supplied	
Unit Title Assessment Report	
Preferred Format:
	
A4 black and white                                                                           (original)
(Approved form by Chief Planning Executive under s180 Unit Titles Act 2001)
•	Approved form completed and signed by the Unit Titles Works Assessor 
•	States the number of units
•	States the class of the units
•	States the proposed commencement date of the development
•	States the proposed completion date of the development
•	States the proposed commencement and completion dates of the development in each stage if a staged development
•	A copy of the relevant development approval
•	Provide evidence that the requirements of Section 2D of the Unit Titles Regulation 2001 have been complied with
	•	Supplied

Certificate of Occupancy and Use
	
Preferred Format:
	
A4 black and white                                                (original or certified copy)
•	Issued by the ACT Planning and Land Authority
	•	Supplied

Asset Acceptance Certificate of Operational Acceptance
	
Preferred Format:
	
A4 black and white                                                                           (original)
•	Issued by Asset Acceptance Section within the Department of Territory and Municipal Services

	•	Supplied
•	Not required	

ActewAGL Certificate of Operational Acceptance
	
Preferred Format:
	
A4 black and white                                                                           (original)
•	Issued by ActewAGL
	•	Supplied
•	Not required

Fitness for Unit Title Certificate
	
Preferred Format:
	
A4 black and white                                                                           (original)
•	Prepared and signed by an eligible building surveyor	•	Supplied
•	Not required

Encroachment/s – Certification that no encroachments exists
	
Preferred Format:
	
A4 black and white                                                                           (original)
•	Prepared and signed by registered surveyor	•	Supplied

Encroachment/s – Certification of encroachment over parcel boundary
	
Preferred Format:
	
A4 black and white                                                                           (original)
•	Prepared and signed by registered surveyor	•	Supplied
•	Not required

Verge/Driveway Inspection Certificate
	
Preferred Format:
	
A5 blue and white                                                  (original or certified copy)
•	Issued by Asset Acceptance Section within the Department of Territory and Municipal Services

	•	Supplied
•	Not required

Driveway Statutory Declaration	
Preferred Format:
	
A4 black and white                                                                           (original)
•	States block identifier
•	States that the driveway has not been changed since the Compliance Certificate for the original residence was issued
•	Signed and dated by Lessee(s)
	•	Supplied
•	Not required

All approved forms are available at www.legislation.act.gov.au

Contact Details:
ACT Planning and Land Authority
Customer Service Centre
GPO Box 1908, Canberra City 2601
16 Challis Street, Dickson ACT 2602
Business Hours: 8.30am to 4.30pm weekdays (excluding Public Holidays)
Phone: (02) 6207 1923		Fax: (02) 6207 1925		TTY: (02) 6207 2622
Email: actpla.customer.services@act.gov.au	Website: www.actpla.act.gov.au

Privacy Notice:
The personal information on this form is being collected to enable processing of your application.  Collection of personal information is authorised by Part 3 and 4 of the Unit Titles Act 2001.  The information that you provide may be disclosed to Government Agencies such as the ACT Revenue Office and the Registrar-General’s Office.