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APPLICATION FOR REGISTRATION

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Please affix adhesive revenue stamps in payment of fees here. If this space is insufficient,
continue on the back of this form where indicated.
For Official Use Only
RECEIVED:
The Land Registration Act No. 3 of 2012 (Section 108)
(Cap. 300) (Repealed)
Form I – Government Lands Act (Chapter 280), rule 2
Form T – Registration of Titles Act (Chapter 281), rule 2
Form G – Land Titles Act (Chapter 282), rule 3
Form A – Registration of Documents Act (Chapter 285), rule 2
ORIGINAL
The Conditions on the Back of this form shall be Complied with
REPUBLIC OF KENYA
APPLICATION FOR REGISTRATION
Of the under mentioned documents in the following order of priority:Date of
Description
Land Reference
Title Deed
Documents
Number
File Number
(1)
(2)
(3)
Number of new certificates of title required at Ksh.125 each ..
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Adhesive revenue stamps fixed hereto to the value of
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Fee
For Official
Use only
(4)
Kshs.
The following documents are enclosed for endorsement:- (5)
Grant No. ………………………. Certificate of Title No………………
Lease No…………………..
The following supporting documents are also enclosed:- (6)
Clearance Certificate
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Land Rent Certificate ..
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“Registration Copy” of Divisional Land Board Consent
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“Registration Copy” of the County Council’s/Commissioner’s Consent
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Valuation forms
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w.70 ..
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Commissioners of Lands or the Chief Engineer, Kenya Railways under the terms of the Grant
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Charge to surrender of lease under section 44 of the Registration of Titles Act (Cap. 281)
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The following consents are endorsed on the documents:-
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Special instructions, including, if necessary, the name and address of the persons to whom the documents are to
be sent if other than the presentor:Signature………………………………..…………………
Name in Block Capitals …………………………………..
Date:……………………………………., 20..…
Postal Address ……………………………………….……
TO BE SUBMITTED IN TRIPLICATE
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