AQ
Form 095

Lodging Party

Box Number

APPLICATION TO NOTE COMPULSORY ACQUISITION
PRIVACY COLLECTION STATEMENT (PRIVACY ACT 1988 (C’WLTH)) OVERLEAF

The applicant applies to the Registrar-General pursuant to Section 41 of the Land Acquisition Act 1989 to note the notice of acquisition as specified below and hereby lodge a copy of the said notice and gazettal for registration.	

1. LAND
Vol:Fol	District/Division	Section	Block	Unit	DP No	
     	     	     	     	     	     	

2.	 APPLICANT
Full Name (Surname Last)
     	Full Postal Address (after acquisition)
     

3. AREA ACQUIRED
     	

4. GAZETTAL
     	

5. EXECUTION
Signed by the Applicant/s

     

Signature of the Applicant/s		Signed in my presence

Signature of Witness

     

Full Name of Witness	

6. 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.