LAND TITLES
OFFICE OF REGULATORY SERVICES
ACT Justice and Community Safety Directorate 

TERMINATION OF CROWN LEASE		
Form 096 - TCL	

	Land Titles Act 1925		

IMPORTANT INFORMATION
This form is to be used to lodge a Termination of Crown Lease under the Land Titles Act 1925 (the Act).  You can access the Act at www.legislation.act.gov.au.  You may also obtain further information and forms at www.ors.act.gov.au. 
	
PRIVACY INFORMATION
The Act authorises the Registrar-General to collect the information required by this form.  The Registrar-General provides identifiable information to various agencies including, but not limited to, the ACT Environment and Sustainable Development Directorate, ACT Treasury Directorate, Canberra Connect and ACTEWAGL for conveyancing, municipal account administrative, statistical and valuation purposes.  These agencies may also use this information to prepare and sell property sales reports to commercial organisations concerned with the development, sale or marketing of land.
	
CONTACT INFORMATION	
Lodge in person at the Office of Regulatory Services:	255 Canberra Avenue, Fyshwick ACT 2609	
Office Hours:	9:00am to 4:30pm Monday to Friday	
General enquiries telephone number:	(02) 6207 0491	
Website address:	www.ors.act.gov.au 
	
INSTRUCTIONS FOR COMPLETION
•	The certificate of title or production of title consenting to the registration of this document is required for lodgement.
•	All information should be typed or clearly printed.  If completing this form by hand please use a solid black pen only.  
•	This office will not accept lodgement of this form if it is not completed in full.
•	Any alteration to information provided on this form must be struck through with a black pen.  Substitute information must be clear and all parties must sign in the margin.  Do not use correction fluid or tape.
•	Ensure all required documents are attached.  If there is insufficient space in any panel, please use an Annexure Sheet.
•	Execution by:
a)	A Natural Person – Should be witnessed by an adult person who is not a party to the document.
b)	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 e.g. “AB by his/her attorney XY pursuant to Power of Attorney ACT Registration No…… of which he/she has no notice of revocation”. (This execution requires a witness).
c)	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:
i.	Two directors of the company;
ii.	A director and a secretary of the company; or
iii.	Where the company is a proprietary company and has a sole director who is also the sole company secretary, that director.  (A witness is not required for this execution).
•	The following forms of execution are suggested –
a)	With A Common Seal
The common seal of ABC Pty Ltd/Ltd ACN…………………
was affixed in the presence of-
...................................(signature)	
...................................(director/secretary)*
(*repeat if necessary i.e. if two directors signing.  If signing as sole director and sole secretary, state ‘director/secretary’) – (A witness is not required for this execution).
b)	Without A Common Seal
Signed by ABC Pty Ltd/Ltd ACN……………………
...................................(signature)	
...................................(director/secretary)*
(*repeat if necessary i.e. if two directors signing.  If signing as sole director and sole secretary, state ‘director/secretary’) – (A witness is not required for this execution). 

	LAND TITLES
OFFICE OF REGULATORY SERVICES
ACT Justice and Community Safety Directorate 

TERMINATION OF CROWN LEASE		
Form 096 - TCL	

	Land Titles Act 1925		

LODGING PARTY DETAILS	
Name	Postal Address	Contact Telephone Number	
     	     	     	

TITLE AND LAND DETAILS	
Volume & Folio	District/Division	Section	Block	
     	     	     	     	

FULL NAME AND POSTAL ADDRESS OF REGISTERED PROPRIETOR/S (Surname Last) (ACN required for all companies)	
     	

TERMINATION NOTIFICATIONS (Must be Certified Copies)	

    Copy of Termination Notice issued to the Lessee/Proprietor

    Copy of Termination Notices issued to any person having an interest in the land comprised in the lease
that is registered under the Land Titles Act 1925

LESSOR’S EXECUTION	

Signed by the person duly authorised by ACT Planning and Land Authority (Please print full name of authorised signatory).

     

Signature of authorised person

Dated -      	
Print full name and address of witness

     

Signature of witness 

Dated -      	

OFFICE USE ONLY	
Lodged by		Certificate of title lodged		
Data entered by		Certificates attached to title		
Registered by		Attachments / Annexures		
Registration date		Production number