Form LRA 14
Form LRA 14
Form LRA 14
28(1), 29(1))
REPUBLIC OF KENYA
Date of Application
Applicant*
Registration Details
(ID/Passport/Registration
No.)
Address in
Kenya (Postal
and Physical)
E-mail address
Telephone
Number
Name:
Address:
ID/Registration details
1
Provide details of the basis and capacity of the applicant to make this application
(a) A statutory declaration.
(iv) In the case of a registered entity, certified extract of the resolution of the entity
seeking an application for a replacement title.
(v) An official search from the registration office where the entity is registered.
(vi) An official search in respect of the Property and/or any other document evidencing
ownership of the Property.
EXECUTION
IN WITNESS WHEREOF this application of a loss or destroyed certificate of Title / lease has
been duly executed by the Proprietor.
SIGNED by the
Proprietor in the
presence of:- Coloured
Photograph
ID/No…………………..
PIN No…………………
Signature………………
Certificate of Verification
LAND REGISTRAR
Name:…………………………... Registrar’s Stamp / No………………
Signature: …………………………………………..
(P.T.O)
STATUTORY DECLARATION***
DECLARED before me at
…………………………………………………
on the ……………day of………….……20…
……………….………………….
……………………………………………..
Signature of Commissioner for Oaths
or Magistrate or Notary Public
*The Applicant should be the registered Proprietor or the person entitled thereto
under the Law.