DEPARTMENT OF LANDS

Application for Consent

To be submitted in TRIPLICATE in respect of each transaction and sent to or left at the

Appropriate office of the commissioner of Lands
To: COMMISSIONER OF LANDS Date……………………..

I HEREBY apply for consent to……………………………………………………………………………………………………………

1. (a) Current registered owner full name in BLOCK LETTERS

…………………………………………………………………………………………………………………………………..

(b) Address……………………………………………………………………………………………………………………..

2. Description of land-;

LR NO. Or Parcel No……………………………………………………………………………...............................................

File number ( if known)…………………………………………………………………………...............................................

Locality……………………………………………………………………………………………............................................

Nature of Development………………………………………………………………………………........................................

3. Proposed purchaser, transferee, mortaggee, charge, tenant, e.t.c (full names in Block Letters)

………………………………………………………………………………………………………..........................................

…………………………………………………………………………………………..............................................................

4. Land Rent………………………………………….cleared up to year……………………………...........................................

Annual Rent clearance certificate number…………………………………..(Attach Duplicate)

5. Incase the application is made by a Law Firm Agency on behalf of the registered owner:

(a) Name of firm / Agency………………………………………………………………………...........................................

(b) Name of Advocate / Agent……………………………………………………………………………………………….

(c) Signature……………………………………………………………………………………….........................................

(d) Official stamp of the firm / Agent……………………………………………………………...........................................

6. Incase the application is the owner

(a) Name…………………………………………………………………………………………….......................................

(b) ID No. ( Attach Copy)……………………………………………………………………................................................

(c) Signature…………………………………………………………………………………….............................................

7. For official use (only)

(a) Consent Fee Receipt No………………………………………………………………………..........................................

(b) Consent issued / Not issued………………………………………………………………………………………………