CERTIFICATE APPROVING REMOVAL OF ENTRY
UNDER SECTION 78(1) OF THE BUILDING ACT 2004
Section 83(3) Building Act 2004
[This Form may also be used for the removal of an entry made under section
37(2) of the Building Act 1991 or 643(2) of the Local Government Act 1974]
Land Registration District(s)
BARCODE
Specified allotments
Unique identifier
Continue on Annexure Schedule(s), if required
All/Part
Legal description
Name of Territorial Authority
Full Name of Registered Proprietor
Certificate
Surname must be underlined
*Insert Unique Identifier of Certificate under s.77, 37(2) or 643(2)
Under section 83(3) of the Building Act 2004, the Territorial Authority has approved the removal
from the computer registers of the specified allotments of the condition under section 75(2) of the
Act (or 37(1) of the Building Act 1991, or 643(1) of the Local Government Act 1974, as the case
may be), entered under No.*
Dated this
day of
20
Signature (Territorial Authority)
Signed by*
*Insert name and designation of signatory in BLOCK letters (unless legibly printed):
A duly authorised Officer of the Territorial Authority
Signature (Registered Proprietor)
Registered Proprietor