LAND TITLES
ACCESS CANBERRA
Chief Minister, Treasury and Economic Development Directorate

APPLICATION FOR A NEW CERTIFICATE OF TITLE (MULTIPLE)		
Form 012 – ACT	

	Land Titles Act 1925		

IMPORTANT INFORMATION

This form is to be used to lodge an application for new certificate of title (many to one) 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 http://www.accesscanberra.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.

INSTRUCTIONS FOR COMPLETION

•	The existing certificate/s of title for the relevant parcel is required to be lodged with this document.
•	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, must state sole director. (No witness is required for this execution). 	

LODGEMENT AND CONTACT INFORMATION
	
Website:
www.accesscanberra.act.gov.au
General Enquiries: 
13 22 81
	In Person:
Environment, Planning and Land Shopfront
Ground Floor South, Dame Pattie Menzies House, 16 Challis Street Dickson
Opening hours - Monday to Friday 8:30am to 4:30pm (excluding public holidays)	

	LAND TITLES
ACCESS CANBERRA
Chief Minister, Treasury and Economic Development Directorate

APPLICATION FOR A NEW CERTIFICATE OF TITLE (MULTIPLE)		
Form 012 – ACT	

	Land Titles Act 1925		
	LODGING PARTY DETAILS	
Name	Email Address	Contact Telephone Number	
     	     	     	

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

PLEASE SELECT IF ONE TO MANY OR MANY TO ONE	
 MANY TO ONE (ST)	 ONE TO MANY (MT)	

TITLE DETAILS	
Number of titles	List Proprietor on 1st Title	Tenancy and Share of Proprietor on 1st Title	
     	     	     	
	List Proprietor on 2nd Title	Tenancy and Share of Proprietor on 2nd Title	
	     	     	
	List Proprietor on 3rd Title	Tenancy and Share of Proprietor on 3rd Title	
	     	     	

NAME AND ADDRESS AND TENANCY OF REGISTERED PROPRIETOR/S – Please complete as would appear on new title
(Surname Last – ACN required for all companies) including post code	
     	

	
EXECUTION	

Print full name of registered proprietor/s

     

Signature or common seal of registered proprietor/s

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