Form C4 "Caveat (Improper Dealings)" - Western Australia, Australia

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FORM C4
WESTERN AUSTRALIA
TRANSFER OF LAND ACT 1893
CAVEAT (Improper Dealings)
DESCRIPTION OF LAND (Note 1)
EXTENT
VOLUME
FOLIO
CAVEATOR (Note 2)
ADDRESS OR FACSIMILE MACHINE NUMBER FOR SERVICE OF NOTICE ON CAVEATOR (Note 3)
REGISTERED PROPRIETOR (Note 4)
ESTATE OR INTEREST BEING CLAIMED
As Registered Proprietor of the Fee Simple and to prevent improper dealings.
The CAVEATOR claims an estate or interest as specified herein of the estate or interest of the abovenamed REGISTERED PROPRIETOR
in the land above described BY VIRTUE OF
Registered Proprietor(s) are concerned that their title may be the subject of identity fraud and the forgery
of instruments and documents purporting to be signed by the registered proprietor(s).
And FORBIDS the registration of any Instrument affecting the estate or interest
Absolutely
Dated this
day of
Year
CAVEATOR OR AGENT SIGN HERE (Note 5)
Signed
In the
presence of
FORM C4
WESTERN AUSTRALIA
TRANSFER OF LAND ACT 1893
CAVEAT (Improper Dealings)
DESCRIPTION OF LAND (Note 1)
EXTENT
VOLUME
FOLIO
CAVEATOR (Note 2)
ADDRESS OR FACSIMILE MACHINE NUMBER FOR SERVICE OF NOTICE ON CAVEATOR (Note 3)
REGISTERED PROPRIETOR (Note 4)
ESTATE OR INTEREST BEING CLAIMED
As Registered Proprietor of the Fee Simple and to prevent improper dealings.
The CAVEATOR claims an estate or interest as specified herein of the estate or interest of the abovenamed REGISTERED PROPRIETOR
in the land above described BY VIRTUE OF
Registered Proprietor(s) are concerned that their title may be the subject of identity fraud and the forgery
of instruments and documents purporting to be signed by the registered proprietor(s).
And FORBIDS the registration of any Instrument affecting the estate or interest
Absolutely
Dated this
day of
Year
CAVEATOR OR AGENT SIGN HERE (Note 5)
Signed
In the
presence of
OFFICE USE ONLY
INSTRUCTIONS
1.
If insufficient space in any section, Additional Sheet, Form B1
should be used with appropriate headings.
The boxed
sections should only contain the words “see page...”
2.
Additional Sheets shall be numbered consecutively and bound
to this document by staples along the left margin prior to
execution by the parties.
3.
No alteration should be made by erasure. The words rejected
CAVEAT
should be scored through and those substituted typed or
written above them, the alteration being initialled by the
(Improper Dealings)
persons signing this document and their witnesses.
NOTES
LODGED BY
1.
DESCRIPTION OF LAND
Lot and Diagram/Plan/Strata /Survey-Strata plan number or
Location name and number to be stated.
ADDRESS
Extent - Whole, part or balance of the land comprised in the
Certificate of Title to be stated.
The Volume and Folio or Crown Lease number, to be stated.
If this document relates to only part of the land comprised in
the Certificate of Title further narrative or graphic description
PHONE No.
may be necessary.
2.
CAVEATOR
FAX No.
State full name of the Caveator.
3.
State the address, or a number for a facsimile machine in
REFERENCE No.
Australia for service of notice on the Caveator.
4.
REGISTERED PROPRIETOR
ISSUING BOX No.
State full name and address of the Registered Proprietor/
Registered Proprietors as shown on Certificate of Title or
Crown Lease and any address/addresses to which future
notices can be sent.
PREPARED BY
5.
CAVEATOR’S OR AGENTS EXECUTION
A separate attestation is required for every person signing this
ADDRESS
document. Each signature should be separately witnessed by
an Adult Person.
The full name, address and occupation of
the witness must be stated. Execution by a corporation or
body corporate must be in accordance with the Corporation
Act
PHONE No.
FAX No.
REFERENCE No.
INSTRUCT IF ANY DOCUMENTS ARE TO ISSUE TO OTHER THAN
LODGING PARTY
TITLES, LEASES, DECLARATIONS ETC LODGED HEREWITH
1.________________________________
Received Items
2.________________________________
No.s
3.________________________________
4.________________________________
5.________________________________
Receiving
6.________________________________
Clerk
Lodged pursuant to the provisions of the TRANSFER OF LAND ACT 1893
as amended on the day and time shown above and particulars entered in
EXAMINED
the Register.
NOTICES TO BE SENT:
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