QUEENSLAND TITLES REGISTRY	BUILDING MANAGEMENT STATEMENT	FORM 32 Version 3

Land Title Act 1994 and Land Act 1994	Page 1 of 1

Dealing Number	Lodger (Name, address, E-mail & phone number)	Lodger
OFFICE USE ONLY Privacy Statement Collection of information from this form is authorised by legislation and is used to maintain publicly searchable records. For more information see the Titles Queensland website.	Code
1. Registered Owners/State Lessees
2. Lot on Plan Description of affected land	Title Reference
3. Execution The Registered Owners/State Lessees of the lots referred to in item 2 reciprocally grant and agree to the terms and conditions of the Building Management Statement contained in:- *the attached schedule; *the attached schedule and document no. ……………….. ; *document no. ……………….. . * delete if not applicable Witnessing officer must be aware of his/her obligations under section 162 of the Land Title Act 1994 signature full name qualification / / Witnessing Officer Execution Date Registered Owner's/ (Witnessing officer must be in accordance with Schedule 1 State Lessee's Signature of Land Title Act 1994 eg Legal Practitioner, JP, C Dec) signature full name qualification / / Witnessing Officer Execution Date Registered Owner's/ (Witnessing officer must be in accordance with Schedule 1 State Lessee's Signature of Land Title Act 1994 eg Legal Practitioner, JP, C Dec)