QUEENSLAND TITLES REGISTRY	HIGH-DENSITY DEVELOPMENT EASEMENT	FORM 39 Version 1

Land Title Act 1994	Duty Imprint	Page 1 of [Total]

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. Registered Owners	Lodger (Name, address, email & phone number)	Lodger Code (if any)
2. Lot on Plan Descriptions of Affected Land	Title Reference
3. Consideration
4. Purpose/s of High-density Development Easement Support (section 95 Land Title Act 1994) Shelter (section 96 Land Title Act 1994) Projections (section 96A Land Title Act 1994) Maintenance of building close to boundary (section 96B Land Title Act 1994) Roof water drainage (section 96C Land Title Act 1994) Note: rule through if purpose is not applicable
5. Grant/Execution The registered owners identified in item 1 reciprocally grant the High-density Development Easement over the land identified in item 2, for the purpose/s stated in item 4, and covenant with each other in terms of Division 4AA of the Land Title Act 1994. 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 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 Registered Owner’s Signature (Witnessing officer must be in accordance with Schedule 1 of Land Title Act 1994 eg Legal Practitioner, JP, C Dec)