Memo Type: LSF.

18 3 6

STATE OF SABAH, MALAYSIA REGISTERED

LAND ORDINANCE, CAP. 68 Register Memo No.

Section 116(1) Memo Seq. No. In Title

Time: …………………………………………………
SCHEDULE XIX
Date:
D D M M Y Y
CAVEA T Nature: CAVEAT- Lot
District Type (WITH CONSENT TO SURRENDER & SUBDIVISION)
Code Code Serial Number CD
By : LEMBAGA
Title No
To : SO
Count of Caveator/s 0 1
….………………………
REGISTRAR
To The Registrar of Titles
TAKE NOTICE THAT
Name Number Name/s (Maximum of 40 characters only)
I/We SO
herein called the caveator
of Kampung Pinang.
claiming an interest in the Land described in the title as numbered above in the district of
whereof Name/s

Count of Name Number

Caveatee/s 0 1 0 0 0 0 0 0 LEMBAGA

of 13-15th Floor,.
hereafter called the caveatee/s is/are (co)owner/s. on the ground that:
we have a caveatable interest as described in Annexure “A”, and save for the dealings in Annexure “B” which
we hereby consent to,

do hereby forbid the registration of any dealing with the above-mentioned land unless such dealing be subject to my /
our consent until this caveat be withdrawn by me / us or cancelled in accordance with the provisions of the Land
Ordinance.

Dated this day of 20

Caveator/s

I/We, the abovenamed caveator/s affirm that the statements in the above caveat are true in substance and in fact
as I/we have been informed and believe.

Caveator/s
Affirm before me this day of 20

Notice Fee: RM30.00

Registration Fee: RM50.00
Receipt No. :
Collector or Magistrate, Notary
Public or Commissioner for Oaths or
Advocate or Justice of the Peace
LSF. 1836 (1982)
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