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Regulation 64

THE REPUBLIC OF UGANDA

THE LAND ACT, CAP 227

THE LAND REGULATIONS, 2004

Form 40

APPLICATION BY OCCUPANT FOR CONSENT TO A LAND TRANSACTON

(to be filled in triplicate)

To: …………………………………….
…………………………………….
……………………………………

PART 1: APPLICATION

PIN:
District County/Division Sub-County/Town Parish/Ward Village/Zone Parcel No.

Block ………………….… Plot ……………………


FRV/LRV ……………… Folio ……………………

I/We ………………………………………………………………………………………………………..
(name(s) and particulars) being the occupant(s) of the above land do hereby apply to deal with
the land in the following manner;

a) assign
b) sub-let
c) sub-divide
d) other (state)*
………………………………………………………………………………………………
……………………………………………………………………………………………….
……………………………………………………………………………………………….
……………………………………………………………………………………………….

(*Delete whichever is inapplicable)

PART 2: CONSENT BY REGISTERED OWNER

I/We ……………………………………………………………………………………………………….. (name


and particulars) being the registered owner(s) of the land consent/do not consent/consent with
conditions to the application to deal with the land you occupy in the following manner;

1
a) ………………………………………………………………………..
b) ……………………………………………………………………….
c) ………………………………………………………………………..
d) ………………………………………………………………………..
e) ……………………………………………………………………….
f) ………………………………………………………………….

Reasons for refusal


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

Conditions (if any)


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

Name and signature, registered owner(s)


(i) ………………………………………………… …………………
(ii) ………………………………………………… ………………….
(iii) ………………………………………………… ………………….

Date ………………..….

In the presence of
Name, signature and address of witness:
……………………………………………… …………………

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