AVCL
Form 044

Lodging Party

Box Number

APPLICATION TO VARY A CROWN LEASE

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

The Minister or the Delegate of the Authority has agreed to vary the lease as described below, subject to the mortgages, encumbrances and other instruments affecting the land including any created by dealings lodged for registration prior to the lodging of this document.	

1. LAND
Vol:Fol	District/Division	Section	Block	Unit	Instrument No/
Associated Dealing No		
     	     	     	     	     	     		
]
2. EXTENSION OF LEASE DATE

     

3. FULL NAME OF REGISTERED PROPRIETOR/S

     

4. POWER TO VARY CROWN LEASE

     

5. DETAILS OF VARIATION

     

6. EXECUTION
Signed by the proprietor/s

Signature of proprietor/s		Full name of witness

Signed in my presence

Signature of witness                                                      	

Signed by the delegate of the Minister/Executive of the Authority

Signature of the delegate of the Minister/Executive of the Authority		Full name of witness

Signed in my presence

Signature of witness                                                      	

	

7. OFFICE USE ONLY
Lodged by	 	Certificates Lodged		
Data Entered by		Attachments Lodged		
Examined by		Certificate of Title Lodged		
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.	Documents must be typed, or completed, in black ink or biro.
2.	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.
3.	If there is insufficient space in any panel use an annexure sheet.
4.	Volume and Folio references must be given.
5.	Provide details of the extension date or grant date.
6.	Provide full names of all proprietors as identified on the certificate of title.
7.	Provide the authority under which the variation is occurring.
8.	Provide the details of the variation.
9.	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 now validly execute a document with or without using a Common Seal if the document is signed by:

a.	Two directors of the company;
b.	A director and a secretary of the company; or
c.	Where the company is a proprietary company and has a sole director who is also the sole company secretary, that director. 
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.