Form:

04BAP
Licence: 98M111
Edition: 0308

Leave this space clear. Affix addit ional

pages to the top left-hand corner.

BANK RU PTCY
A PPLIC ATI ON
Ne w S o u t h W al es
Sec ti on 9 0 Re al Pr oper t y A c t 19 00

PRI V A C Y N O T E : S ec ti on 31B o f the Re a l P rope r t y A c t 1 9 00 (R P A c t ) a uthoris es the R e gis tra r Ge ne r al t o c ol le ct the i nfor m a ti on
re qui re d b y thi s f o rm fo r the e sta bl is hm e nt a nd m ai nte na nc e o f the R e a l P roper t y A c t Re gis te r. Sec ti on 96B R P A c t re qui re s tha t
the Re gis ter is m a de av ai l a bl e t o a ny pe r s o n f o r s ea r c h u p o n pa y me nt o f a fee , i f a ny.
(A) L A N D
Torrens Tit le

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(B) R E GIS T E R E D
DE ALI N G

Nu mber

(C) L OD G E D B Y

Delivery
Box

Torrens Title

C O DE

Name, Address or DX and Telephone

Reference (optional):

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AP

(D)

BA NK RUP T/
D E B T OR

(E)

AP P LI C A NT

(F)

The applicant applies to be registered as proprietor of all the estate or interest o f the abovementioned bankrupt/debtor in the
land/registered dealing referred to above. The applicant claims as trustee of the bankrupt/debtor by virtue of section . . . . . . . . . . . . . . . . . . . . .
of the Bankruptcy Act 1966 pursuant to

(G)

sequestration order dated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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The applicant certifies that the bankrupt/debtor named therein is identical to the bankrupt/debtor referred to above.
DATE

...........

dd
(H)

/ . . . . . . . . .. . / . . . . . . . . . . . . . . . . .
mm

yyyy

I cert ify that the app licant, with who m I am personally acquainted

Cert ified co rrect for the purposes of the Real

or as to whose identity I am otherwise satisfied, signed this application

Property Act 1900 by the applicant.

in my presence.
Signature of witness:

Signature of applicant:

Name of witness:

Address of witness:

AL L

H A N D W R IT I N G M U S T B E IN B L O C K C A P IT A L S .

P age 1 of

.. ...... ...

A set of instruct ions fo r co mpleting th is fo rm

is available fro m the Depart ment of Lands,
Land and Prop erty In fo rmat ion Div is ion .