Lodging Party

Box Number

ST
Form 067

APPLICATION FOR NEW CERTIFICATE 
OF TITLE
(Single Title – Many to One)
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/S (Complete where Applicant Is NOT a registered proprietor)
     	

5. DATE
     	

6. EXECUTION
Signed by the applicant/s

Signature of applicant/s		Signed in my presence

Signature of witness                                                      

Full name of witness	

7. OFFICE USE ONLY
Lodged by	 	Certificates Lodged		
Data Entered by		Attachments Lodged		
Examined by		New Volume Folio Number		
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.	This form is to be used by joint tenants/tenants in common where there are many individual certificates of title identifying individual shares, that are then handed in and merged into one certificate of title.
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 of the applicant and address for 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 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. 

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.