44-46 South Quay, Port of Spain, Tel: 623-(HOME) 4663 ext.

3100
RESIDENTIAL LOTS APPLICATION FORM
Section A: MAIN APPLICANT'S PERSONAL INFORMATION
Surname First Name Other Names

ID Card No. Drivers Permit No. Passport No. Birth Certificate Pin No. (Top Left No.)

Date of Birth (DD/MM/YYYY) Gender (MALE/FEMALE) TT Citizen (YES/NO) TT Resident (YES/NO) Country of Birth
__ __ / __ __ / __ __ __ __
Marital Status: Single □ Married □ Divorced □ Separated □ Common Law □ Widowed □
Residential Address:

Mailing Address (if different from residential):

Telephone - Home Work Cell Email

Total Monthly Income Income Source: Pension □ Self Employed □ Employed □ Other□

If “Other” Specify :
Are you in the Protective Services? Yes □ No □ Place of occupation:
E.G. T&T - Police Service, Defense Force, Fire Service, Prison Service
Sector of Occupation: State □ Private □ Other :
Do you own or are you a part owner of any property? YES □ NO □
If Yes, Please specify Location:
Are you Squatting? YES □ NO □
If Yes, Please Specify Location: State Lands □ Private Lands □ Unknown / Uncertain □
Select which area the Land is being requested and state name of area:
North East □ North West □ South West □ East West Corridor □ Central □ South East □
SECTION B: CO-APPLICANT'S PERSONAL INFORMATION
Surname First Name Other Names

ID Card No. Driver's Permit No. Passport No. Birth Certificate Pin No. (Top Left No.)

Date of Birth (DD/MM/YYYY) Gender (MALE/FEMALE) TT Citizen (YES/NO) TT Resident (YES/NO) Country of Birth
__ __ / __ __ / __ __ __ __
Marital Status: Single □ Married □ Divorced □ Separated □ Common Law □ Widowed □
Residential Address:

Mailing Address (if different from residential):

Telephone - Home Work Cell Email

Total Monthly Income Income Source: Pension □ Self Employed □ Employed □ Other□

If “Other” Specify : _______________________________

Are you in the Protective Services? Yes □ No □ Place of occupation:
E.G. T&T - Police Service, Defense Force, Fire Service, Prison Service
Sector of Occupation: State □ Private □ Other :
SECTION C: HOUSEHOLD INFORMATION
Please specify total number of occupants per household including yourself :
NAME Date of Birth
Relation to Main Applicant State Disability
FIRST NAME SURNAME (DD/MM/YYYY)
__ __ / __ __ / __ __ __ __

__ __ / __ __ / __ __ __ __

__ __ / __ __ / __ __ __ __

__ __ / __ __ / __ __ __ __

__ __ / __ __ / __ __ __ __

__ __ / __ __ / __ __ __ __

__ __ / __ __ / __ __ __ __

I/ We…………………………………………………………………………………. certify that the information given in this form is true to the best of my/our
knowledge and belief. If there is anything given in the information above which is not true or incorrect, knowingly or unknowingly then the
Land Settlement Agency reserves the right to refuse this application.

Applicant's Signature: Date:

Co-Applicant's Signature: Date:

All information provided is subject to verification. Applicants are reminded that all criteria must be met for further consideration.
 GUIDELINES
Who are eligible to apply?

 Any citizen or legal resident of Trinidad and Tobago,

 Any person 18 years and over; and
 Not be the owner/part owner of or have a share or interest in any real property (house or land) in
Trinidad and Tobago at the time of submitting an application and at the time of allocation of the lot,
if successful.

Use this map as a guide when selecting the preferred area for which land is being requested.
NOTE: This does not guarantee you will be allocated a lot in the preferred location.

THE APPLICATION PROCESS

WALK-IN APPLICATIONS:
 Applicant must come in with his/her completed application form along with proper identification
(National I.D, Drivers Permit, Birth Certificate, Passport) where applicable.
 The application form will be verified and entered onto our database and a letter bearing your
unique reference number confirming acceptance of your application will be issued to you.
NOTE: Incomplete forms will not be entered.

ONLINE APPLICATIONS:

Complete the application form on the Ministry’s website (http://www.mhe.gov.tt/).

Once you have successfully completed and submitted the form, a unique reference number will be
generated for you. You will then be prompted to print:
-your completed application form that you submitted
-a letter bearing your unique reference number confirming acceptance of your application

In both cases, the unique reference number will allow you to check on your application and to update
any changes in your status.
OFFICES OF THE LSA

Orange Grove Road South, The HDC Building,

Orange Grove Estate, Corner Flamingo Road and the Old Southern
Tacarigua Main Road, Couva
623-4663 ext. 3100 623-4663 ext. 3353/3354

Agostini Building #1 Factory Road,

Corner South Quay and Duncan Street, Ste. Madeleine
Port-of-Spain 623-4663 ext. 3351/3352
299-4095