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Application to be Registered
Proprietor by Survivorship
Section 100 Land Titles Act 1980
The applicant/s as surviving joint tenant(s) do/does hereby apply to be registered as proprietor(s) of the estate and
interest held jointly with the deceased in the land described hereunder.
DESCRIPTION OF LAND
Folio of the Register
Folio
Volume
Volume
<<Buy|Enquiry
Information|FromExisting|Vo
lume>>
Folio
<<Buy|Enquiry
Information|FromE
xisting|Folio>>
Applicant/s:
<<Buy|Name Changes|deceasedName>>
Date: ............................................
Signed by the Applicant
Signed: .........................................
Witness: .........................................
.........................................
.........................................
.........................................
(signature, name, occupation & full postal address)
RPS
Version 1 (TOLD)
THE B ACK OF THIS FORM MUS T NOT B E US ED
Created 30-Dec-2006 06:58PM
.............................................................
Folio of the Register Reference:
(First reference stated on accompanying dealing)
Vol.<<Buy|Enquiry
............................. Fol. <<Buy|Enqu
...........
Information|FromE
xisting|Volume>>
iry
Information|
Full Address of Transferor/Vendor
FromExistin
(For the purposes of Future Notices)
g|Folio>>
(Only if other properties still owned by vendor)
Particulars of Sale
Chattels: $............................
Goodwill: $............................
Land Purchased/Acquired is
Whole
Part
<<Buy|Settlement|DateOfExc
YES
NO
By selecting YES to this question, you are stating that this property is to be used by the transferee/purchaser as their principal place of residence as at 1st July
following settlement. This means that the property will not be subject to land tax. By selecting NO to this question, you are stating that this property is not to be used
by the transferee/purchaser as their principal place of residence and therefore may be subject to land tax. Note: The owner must notify the Commissioner of State
Revenue in writing within 30 days of the property ceasing to be used as their principal place of residence.
.............................................................
Dimensions/Area
.............................................................
It is hereby declared that the information contained herein is true and correct.
Name & Signature of Person giving Notice:
.............................................................
.............................................................