QUEENSLAND TITLES REGISTRY	SURRENDER OF CARBON ABATEMENT INTEREST	FORM 37 Version 1

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

Dealing Number
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.
1. Dealing number of Carbon Abatement Interest being surrendered	Lodger (Name, address, email & phone number)	Lodger Code (if any)
2. Lot on Plan Description	Title Reference
3. Grantor
4. Grantee
5. Surrender/Execution Surrender of Carbon Abatement Interest *Full Surrender The Carbon Abatement Interest in item 1 is surrendered from / / . *Partial Surrender The Carbon Abatement Interest in item 1 is surrendered from / / *so far as relates to the land in item 2. *so far as relates to part of the Carbon Abatement Interest area identified on/as . * 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 Grantee’s Signature (Witnessing officer must be in accordance with Schedule 1 of Land Title Act 1994 eg Legal Practitioner, JP, C Dec) signature full name qualification / / Witnessing Officer Execution Date Grantor’s Signature (Witnessing officer must be in accordance with Schedule 1 of Land Title Act 1994 eg Legal Practitioner, JP, C Dec)