You are on page 1of 1

NATIONAL LAND AGENCY

93 Hanover Street,
Kingston,
Tel: (876) 750-LAND 946-LAND
Fax: (876) 922-3858

TO : REGISTRAR OF TITLES DATE: ________________________

FROM (COMPANY NAME) : _______________________________________________

BEARER’S NAME : _______________________________________________

CONTACT # : _______________________________________________

COMPANY EMAIL ADDRESS : _______________________________________________

I HEREBY AUTHORIZE THE OFFICE OF TITLES TO DEDUCT THE


REGISTRATION FEE FROM MY DEPOSIT ACCOUNT.

RECEIVED BY : _______________________________________________

----------------------------------------------------------------------------------------------------------------------

NATIONAL LAND AGENCY


93 Hanover Street,
Kingston,
Tel: (876) 750-LAND 946-LAND
Fax: (876) 922-3858

TO : REGISTRAR OF TITLES DATE: ________________________

FROM (COMPANY NAME) : _______________________________________________

BEARER’S NAME : _______________________________________________

CONTACT # : _______________________________________________

COMPANY EMAIL ADDRESS : _______________________________________________

I HEREBY AUTHORIZE THE OFFICE OF TITLES TO DEDUCT THE


REGISTRATION FEE FROM MY DEPOSIT ACCOUNT.

RECEIVED BY : _______________________________________________

You might also like