IMPORTANT NOTICE The information contained in this instrument forms part of the public records available for inspection and search by members of the public upon payment of a fee. The information is collected and used for the purpose of maintaining the land register pursuant to the Land Titles Act.

ND Form 48 Ver 2 This form may take you 5 minutes to fill in.

THE LAND TITLES ACT (For Official use only) NOTICE OF DEATH

(A) DESCRIPTION OF LAND

*CT/SSCT/SCT MK/TS Lot No Property Address Volume Folio

Lease No.

(B) DECEASED REGISTERED PROPRIETOR

Name :

The DECEASED and the APPLICANT(S) are registered as joint tenants of the land above described.

(C) THE APPLICANT

ID / Co regn no : Name :

Address:

The surviving joint-tenant/s, HEREBY APPLIES for an entry to be made on the land register of this entitlement.

(D) EVIDENCE OF DEATH (original or certified true copy)

Death Certificate number ______

Grant of Probate number ______

Letters of Administration number ______IMPORTANT NOTICE The information contained in this instrument forms part of the public records available for inspection and search by members of the public upon payment of a fee. The information is collected and used for the purpose of maintaining the land register pursuant to the Land Titles Act.

Please tick the appropriate box

(E) DATE OF APPLICATION : ______

(F) EXECUTION BY APPLICANT

______SIGNATURE

Witness ______IMPORTANT NOTICE The information contained in this instrument forms part of the public records available for inspection and search by members of the public upon payment of a fee. The information is collected and used for the purpose of maintaining the land register pursuant to the Land Titles Act.

FOR OFFICE USE ONLY

REGISTERED ON

Initials of Signing Officer : for REGISTRAR OF TITLES

Note : - This portion shall be printed or typed on the reverse side of the last page of the instrument.