STATUTORY DECLARATION

for Transmission by Survivorship on death of registered owner

(to be retained with Client Authority and Instruction, pursuant to section 30 Land Transfer Act 2017) 

Insert names, addresses and details where indicated and delete phrases in [ ] as required

I,
of

and I,
of

solemnly and sincerely declare that:

1.	I am/we are the survivor(s) of

	deceased, a certified copy of the entry of whose death in the Register of Deaths is annexed hereto marked ‘A’.

2.   Date of death

3. 	The deceased and the person named as *                                                                    in record of title(s), …………..,  were one and the same person.

4.  At the time of his/her death, the deceased and I/we were registered as the owner as joint tenants of an estate or interest comprised in the said record of title
     [in our own right and free from all trusts and equities].
	[subject only to **                                                                                                                   ].

5. 	I/We truly believe myself/ourselves to be entitled to be registered as owner(s) of the said estate or interest by virtue of my/our survivorship of the deceased.

And I/we make this solemn declaration conscientiously believing the same to be true and by virtue of the Oaths and Declarations Act 1957.

DECLARED at                                                 )
this               day of                             20        )
before me:                                                      )

A person authorised to take a statutory declaration under the Oaths and Declarations Act 1957

* Insert name of deceased owner shown on the register
**State details of any trusts or equities