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QUEENSLAND LAND REGISTRY Land Title Act 1994 and Land Act 1994 REQUEST TO DISPENSE WITH PRODUCTION OF INSTRUMENT / DOCUMENT FORM 17 Version 4 Page 1 of Lodger Name address E-mail phone number Dealing Number OFFICE USE ONLY Lodger Code Privacy Statement Collection of this information is authorised by the Land Title Act 1994 and the Land Act 1994 and is used to maintain the publicly searchable registers in the land registry and the water register. For more information about privacy in DNRM see the department s website. Type of missing document certificate of title or tenure document Lot on Plan Description Registered Owner/Lessee Applicant Request by Applicant a The applicant makes this request as. eg registered owner etc b The missing certificate of title/tenure document is not deposited with any person as security for any purpose or for safe custody. c The facts and circumstances of the loss or destruction of the missing certificate of title/tenure document and efforts to locate it are set out in the attached declaration* d It is requested that County Parish Title Reference the production of the missing certificate of title/tenure document be dispensed with for the purpose of cancellation registering. insert type of instrument to be registered delete if not applicable Witnessing officer must be aware of his/her obligations under section 162 of the Land Title Act 1994. For more information about privacy in DNRM see the department s website. Type of missing document certificate of title or tenure document Lot on Plan Description Registered Owner/Lessee Applicant Request by Applicant a The applicant makes this request as. eg registered owner etc b The missing certificate of title/tenure document is not deposited with any person as security for any purpose or for safe custody. eg registered owner etc b The missing certificate of title/tenure document is not deposited with any person as security for any purpose or for safe custody. c The facts and circumstances of the loss or destruction of the missing certificate of title/tenure document and efforts to locate it are set out in the attached declaration* d It is requested that County Parish Title Reference the production of the missing certificate of title/tenure document be dispensed with for the purpose of cancellation registering. c The facts and circumstances of the loss or destruction of the missing certificate of title/tenure document and efforts to locate it are set out in the attached declaration* d It is requested that County Parish Title Reference the production of the missing certificate of title/tenure document be dispensed with for the purpose of cancellation registering. insert type of instrument to be registered delete if not applicable Witnessing officer must be aware of his/her obligations under section 162 of the Land Title Act 1994. For more information about privacy in DNRM see the department s website. Type of missing document certificate of title or tenure document Lot on Plan Description Registered Owner/Lessee Applicant Request by Applicant a The applicant makes this request as. eg registered owner etc b The missing certificate of title/tenure document is not deposited with any person as security for any purpose or for safe custody. c The facts and circumstances of the loss or destruction of the missing certificate of title/tenure document and efforts to locate it are set out in the attached declaration* d It is requested that County Parish Title Reference the production of the missing certificate of title/tenure document be dispensed with for the purpose of cancellation registering.

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Keywords relevant to Form 17 Printable

  • EG
  • lessee
  • Lodger
  • qualification
  • applicable
  • Dec
  • dispensed
  • Applicant
  • registers
  • Practitioner
  • Authorised
  • registering
  • Witnessing
  • Registry
  • cancellation
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