Please note : Ensure that all details entered in this form are correct and are completed in black capitals for ease and legibility. These details will be used on all documentation and cannot be altered. Please also enter full particulars.

 

 

Land Name Required:

Mayfair, Your Hometown etc  …………………………………………………………………………..

Title Required:

…………………………………………………………………………………………………….

Lord, Sir, Earl, NB Please Remember for the Title of Lord alone then this is all that need be entered but for the Title of Lord of the Manor then please enter Lord of the Manor    

Present Title:

Example Miss, Mrs, Mr, Master ………………………………………………………………………..

First Name:

Example Joseph not Joe  - Catherine not Cathy : ………………………………………………….

Middle Names:

Example johnathan not simply ‘J’ : …………………………………………………………………...

Last Name:

………………………………………………………………………………………………………………..

Date Of Birth:

Day : ………………….  Month: …………………………… Year: ……………………….……………

Nationality:

………………………………………………………………………………………………………………..

 

 

Postal Address:

………………………………………………………………………………………………………………..

 

………………………………………………………………………………………………………………..

Postal Code:

………………………………………………………………………………………………………………..

Country:

………………………………………………………………………………………………………………..

Telephone No.:

(……………) ……………………………………………….……………………………………………….

Mobile No.:

(……………) ………………………………………….…………………………………………………….

Email Address:

…………………………………….………. @ ………………………….…………………………………

 

 

 

 

I wish to purchase the Title as so entered in the sum of £875. I enclosed my payment by the following means (please tick box to indicate payment method ):- Important! Should you wish your spouse and/or children to hold a Title and be included upon the Land Registry Certificate as Joint Purchasers then they must complete and sign the Second and/or subsequent Applications.

 

·          International Money Order

·          Personal Cheque

 

Made Payable to Fantaysia ‘The Homestead’ Thurnscoe Road, Bolton-on-Dearne, Rotherham, South Yorkshire. S63 8JW

 

We also accept payment online via either of these secure payment methods. (please tick box to indicate payment method ):-

 

·          Nochex

·          Paypal

·          World Pay

 

Please ensure that you have signed the form below and that you have stated your name, address and telephone number on the payment receipt if paying via any of the online payment methods. Also ensure that you have sent your completed form in the post. We are sorry but we cannot accept faxed or emailed applications forms.

 

Signature :

……………………………………………………………………..

Date:

……………………………………………………………………..

 

 

 

Get 4th Application Form