For Official Use Only

Affix adhesive revenue in payment of the fee here

No. .
Received

Form C-The Trustees (Perpetual Succession Chapter 164) Act

Form Y-Registration ofTitle Act (Chapter 281 ), Rule 3
Form J-Govemment Lands Act (Chapter 280), Rule 2
Form J-Land Titles Act (Chapter 282), Rule 3
Form C-Registration of Documents Act (Chapter 285) Rule 2

REPUBLIC OF KEN YA

THE REGISTRATION OF TITLES ACT

(CAP 281)

APPLICATION FOR COPY

TO: THE REGISTRAR,

Our Reference: ................................ ..

LAND REGISTRY, NAIROBI/MOMBASA

II we request you to supply certified copies of the following:

PARTICULARS OF THE APPLI CANT/ADVOCATE:

Full Names ............................................................... Signature .................................................. ..
Identity Card Number/Passport (Attach copy) ............................................................................. .
Personal Identification Number (Attach copy} .............................................................................. .
Postal Address ................................................................................................................................ .
Telephone (Office): ............................................................. Cell phone: .......................................
Purpose of search ........................................................................................................................... .
Owner of property ...........................................................................................................................
Proposed purchaser of property .........................................; ...........................................................
Advocate I Agent .............................................................................................................................

Adhesive revenue stamps at-the rate of KSh. 520 (Five hundred and twenty only) per
certified copy are pinned to this application to meet the stamp duty payable thereon.

Date this ....................... day of........................................ 20 .................

FOR OFFICIAL

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ONLY

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