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Privacy Collection Statement The informat ion under this form is collected under statutory authority and is used for the purpose of maintaining publicly searchable registers and indexes in the Victorian Land Reg istry.
Lodged at the Office of Titles by: Name: Phone: Address: Ref: Customer Code:
The applicant applies for an order vesting the land in applicant for the estate specified free of encumbrances.
Land: Applicant: Estate:
Date: Signed: