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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. |
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Land Name
Required: |
Mayfair,
Your Hometown etc
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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 |
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Present Title: |
Example
Miss, Mrs, Mr, Master
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First Name: |
Example
Joseph not Joe - Catherine not Cathy :
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Middle Names: |
Example
johnathan not simply J :
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Last Name: |
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Date Of Birth: |
Day :
. Month:
Year:
.
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Nationality: |
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Postal Address: |
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Postal Code: |
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Country: |
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Telephone No.: |
(
)
.
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Mobile No.: |
(
)
.
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Email Address: |
.
.
@
.
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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 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. |
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Signature
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Date: |
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