Land registry county

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Application for first registration where title is based on possession (Rule 17)
I, A.B., of , make oath and say —
1. I, (and my predecessors in title) have been in sole and exclusive beneficial occupation of the (describe the property) property shown on the application map attached edged red and lettered (which application map correctly shows the boundaries of the property) for upwards of years last past, and/or in sole receipt of the rents and profits thereof and no acknowledgment has been given by me (us) in favour of any person in respect of same or any part thereof.
2(a) (Describe how the occupation began and set out such facts as are relied upon in support of the applicant's claim to have established his/her title, e.g., deliberate squatting with intention to acquire the property; taking possession as one of the next-of-kin of a deceased owner against the personal representative of such owner, other next-of-kin, etc.; uses made of the property; the persons against whom he/she claims to have acquired his title, departures or dispossessions, relevant deaths; next-of-kin, addresses for service of notices, etc.).
2(b) (The title against which adverse possession is claimed should be set out. If a fee farm grant or leasehold full details in the applicants possession or procurement should be set out. If the title is unknown the efforts made to establish the title should be fully set out)
3. I am entitled for my own benefit to the fee simple interest in the property (or, otherwise as the case may be) and I am not aware of any contract or agreement for sale, or of any mortgage, charge, lease, agreement for lease, restrictive covenant, lien, incumbrance or trust (or, except as stated in the Schedule hereto) affecting the property, or any part thereof, and I declare that there is no person in possession or occupation of the property or any part thereof adversely to my estate or interest therein.
4. I am not aware of any question or doubt affecting the title to the property, or any part thereof, or of any matter or thing whereby the title is, or may be impeached, affected, or called in question in any manner whatsoever.
5. There is not to my knowledge any person interested in the proceedings on the said application who is under the age of 18 years, or is of unsound mind, (except - give name and address of any person interested who is a minor (see Note (3)) or of unsound mind and of his/her guardian or committee, or trustees under Section 57 of the Succession Act, 1965, if any) and no proceedings are pending in any court relating to the said property (except - give particulars of any pending action or suit).

6. The contracts, abstracts, legal opinions, requisitions, replies, deeds, wills and other documents referred to or lodged with said application and produced in the proceedings thereunder are all the documents in my possession or under my control (or, in the possession of or under his/her control) relating to the said property.

  1. I apply to be registered as full owner with an absolute title (or, qualified title (qualified as to ) or, good leasehold title or, possessory title) of the property set out in paragraph 1.


(where necessary)

Signature of deponent.

I. X.Y., hereby certify that I know the deponent.


Sworn this the day of , 20 ,

at in the county of before me a Commissioner for Oaths (or other qualified person) and I know the deponent

(or, I know X.Y., who certifies his/her knowledge of the deponent).


Note (1) - Where the application is based on possession of registered land, Form 6 should be used and not this form.

Note (2) - This form can be used where the applicant has no documents of title in his/her possession or control (see Rule 17).
Note (3) - Please note that an interest vesting in a minor creates a trust in land by virtue of Part 4 of the Land and Conveyancing Law Reform Act 2009. The guardians of a minor do not necessarily have capacity to act as trustees on his/her behalf (see Section 19 of the 2009 Act).
Note (4) - The relevant averments of Form 16 are included in Form 5.
Note (5) - If the application is made on behalf of a corporate body it may be made by the Secretary or Law Agent or it may be made by a person duly authorised by that body if it is averred that the person is duly authorised and has the necessary means of knowledge.

    Note (6) - A certificate by the Revenue Commissioners pursuant to Section 62(2) of the Capital Acquisitions Tax Consolidation Act 2003 [as amended by Section 128 of the Finance Act 2008] or, if appropriate, a solicitor’s certificate in the form prescribed by Section 62(7) of the Capital Acquisitions Tax Consolidation Act 2003 [as amended by Section 128 of the Finance Act 2008] should be lodged.

Note (7) - If there is more than one applicant, the form should be amended accordingly.

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