Application For A Certificate Of Leasehold Title - Yukon Land Registration District
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1Land Titles Act, 2015 — YUKON LAND REGISTRATION DISTRICT
APPLICATION FOR A
CERTIFICATE OF LEASEHOLD TITLE
(s. 53)
TO THE REGISTRAR:
Applicant(s): ________________________________________________________________
(insert full name of applicant(s)/lessee(s))
Mailing Address to be shown on title: ______________________________________________
_____________________________________________________________________________
I/We apply for the issuance of a Certificate(s) of Leasehold Title in my/our name(s) for the
land(s) described below, pursuant to the following lease (“Lease”):
Lease dated: ____________________ registered under Instrument No: ____________
Legal Description:
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Provide Primary Certificate of Title number(s) to which Leasehold Title shall attach:
_____________________________________________________________________________
In the name(s) of the following applicant(s)/lessee(s)
_____________________________________________________________________________
(insert full name(s) of applicant(s)/lessee(s)) and tenancy type)
Note: Tenants-in-common require percentages indicating applicants’ interest in the property.
For a term of __________ years.
The Lessee(s) has/have the right to purchase the land described in the lease.
Applicant(s)/lessee(s) acknowledge and agree that, for the purposes of s. 53(2) that the Lease
contains or shall be deemed to contain each of the following encumbrances:
_____________________________________________________________________________
(List registration numbers of all charges, liens and interests shown on the certificate of title
and if no encumbrances, please state “NIL”)
Date: ____________________, 20_______
SWORN / AFFIRMED BEFORE ME
)
at _____________ in _______________
)
______________________________________
on the ____ day of __________, 20____
)
(Signature)
)
__________________________________
)
______________________________________
(Signature of Notary or Commissioner)
)
(print full name)
)
__________________________________
)
(print full name)
)
______________________________________
)
(Signature)
Notary Public in and for Yukon;
)
or Notary Public or Commissioner for Oaths
)
______________________________________
in and for ___________________
)
(print full name)
(My commission expires:___________)
)
)
* All Notaries and Commissioners outside of Yukon must affix seal
RO: 1
June 20, 2016
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