DSJT / Form 17 / Ver 2

(For Official use only)

APPLICATION OF DECLARATION

BY A JOINT TENANT

TO SEVER A JOINT TENANCY

(A)DESCRIPTION OF LAND

*CT/SSCT/SCT /

MK

/ TS / Lot No / Property Address
Vol / Fol
* Whole/______undivided share in the land

(B) I, the Declarant

ID / Co regn no
Name
Citizenship / Place of Incorporation
Non-Citizen / * Permanent Resident / Non-Permanent Resident
Address
(within Singapore for service of notice)

HEREBY do solemnly and sincerely declare that I am the registered proprietor of the land as joint tenant together with the other Registered Proprietor/s hereinafter mentioned and that I wish to sever the joint tenancy and hold the land as a tenant in common with the other Registered Proprietor/s in the share proportionate to the number of joint tenants.

* Please delete what is not applicable

(C) OTHER REGISTERED PROPRIETOR OF LAND

ID / Co regn no
Name
Address
(within Singapore for service of notice)

And I make this solemn declaration by virtue of the provisions of the Oaths and Declarations Act (Cap. 211), and subject to the penalties provided by that Act for the making of false statements in statutory declarations, conscientiously believing the statements contained in this declaration to be true in every particular.

EXECUTION BY DECLARANT

Declared at Singapore:

By the Declarant: ______

Signature

Date: ______

Before me: ______

Commissioner for Oaths

(D) ENDORSEMENT OF SERVICE

Note: To be endorsed on the instrument of Declaration and to be completed only

AFTER the Instrument of Declaration has been sworn and a copy of the Instrument of Declaration has been served on the other Registered Proprietor.

I, ______the Declarant, hereby do solemnly and sincerely declare that to the best of my information, knowledge and belief a copy of this Instrument of Declaration dated ______has been duly served on the other Registered Proprietor named in this Instrument of Declaration by my solicitor *personally/by registered post on ______.

And I make this solemn declaration by virtue of the provisions of the Oaths and Declarations Act (Cap. 211), and subject to the penalties provided by that Act for the making of false statements in statutory declarations, conscientiously believing the statements contained in this declaration to be true in every particular.

*Please delete what is not applicable

EXECUTION BY DECLARANT:

Declared at Singapore

By the Declarant: ______

Signature

Date:______

Before me: ______

Commissioner for Oaths

(E) CERTIFICATE OF CORRECTNESS

I, the solicitor for the Declarant hereby certify that this instrument is correct for the purposes of the Land Titles Act and that I hold a practising certificate which is in force as at the date of the instrument.

.

______

NAME & SIGNATURE OF SOLICITOR FOR THE

DECLARANT

FOR OFFICE USE ONLY

REGISTERED ON

Initials of

Signing Officer :for REGISTRAR OF TITLES

Received on ______STARS CT/SSCT NE ( ) ______

______

Regn O/CClerk’s Name & Signature

______

Del O/CName of Law firm

Note : - This portion shall be printed or typed on the reverse side of the last page of the

instrument.