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 For Official Use Only RECEIVED: The Land Registration Act No. 3 of 2012 (Section 108) (Cap. 300) (Repealed) Form I – Government Lands Act (Chapter 280), rule 2 Form T – Registration of Titles Act (Chapter 281), rule 2 Form G – Land Titles Act (Chapter 282), rule 3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 .. .. .. .. .. Adhesive revenue stamps fixed hereto to the value of .. .. .. .. .. .. 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 .. .. .. Land Rent Certificate .. .. “Registration Copy” of Divisional Land Board Consent .. .. .. .. .. “Registration Copy” of the County Council’s/Commissioner’s Consent .. .. .. Valuation forms .. .. .. .. w.70 .. .. .. .. .. .. .. .. .. .. .. .. .. .. Commissioners of Lands or the Chief Engineer, Kenya Railways under the terms of the Grant .. .. .. Charge to surrender of lease under section 44 of the Registration of Titles Act (Cap. 281) .. .. .. The following consents are endorsed on the documents:- .. 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
