APPLICATION TO FREEHOLD A CROWN LEASE

1. This form is to be used to apply to surrender a Crown lease in order to purchase the land pursuant to sections 24, 25 and 37 (and 37A where applicable) of the Crown Land Management Act 2009. It is best completed via a desktop using a modern browser.

2. Submission of this form requires payment of $510.00 (GST inclusive) by MasterCard or Visa (please note application fees may not be refundable). Other application form and payment options are available.

3. Land Services SA requires a registered conveyancer or legal practitioner to lodge the documentation associated with the surrender and freeholding of a Crown lease.

4. This form does not apply to pastoral leases managed under the Pastoral Land Management and Conservation Act 1989. Please refer to the Pastoral Unit.

5. Please contact DEWShacks@sa.gov.au regarding shack leases.

6. The information provided on this form may be used in accordance with the Government of South Australia's Information Privacy Principles. You are encouraged to read the Department for Environment and Water's Privacy Statement.

7. Please email the Crown Lands Program or phone 8429 7680 if you require any assistance.

Crown land details

For information about how to obtain land details refer to South Australian property and planning atlas.

Title Reference

Volume number

Folio number

Parcel type

Parcel number

Plan type

Plan number

Hundred name

Location (Suburb/Town)

Are there additional land parcels? *

YesNo

Title reference

Volume/Folio

Land descriptionSection/Allotment, Plan type, Plan number

Lease details

Lease number(s) *

Lease type *

PerpetualTerm

Term expiry date *

Section 25(1)(ca) of the Crown Land Management Act 2009 requires evidence that a lessee has constructed or made significant improvements on the land. Please list fixtures/improvements and approximate value. *

Conveyancer/Legal Practitioner details

Title

First name *

Middle name (s)

Last name *

Business name *

Email address *

Contact phone number *

Postal address *

Street address *

I have verified the identity of my clients *

Yes No

I confirm that all named lessees support this application *

YesNo

Lessee details

Please note - the names provided below must match the names recorded on the current lease.

Lessee type *

Title

First name *

Middle name(s)

Last name *

Legal/Business name *

ABN

ACN

Postal address *

Suburb/Town *

State *

Postcode *

Email *If no email address, please type no@email.com

Contact phone number *

Are there any other lessees? *

YesNo

Lessee type *

Title

First name *

Middle name(s)

Last name *

Legal/Business name *

ABN

ACN

Postal address *

Suburb/Town *

State *

Postcode *

EmailIf no email address, please type no@email.com

Contact phone number *

Are there any other lessees? *

YesNo

Lessee type

Title

First name *

Middle name(s)

Last name *

Legal/Business name *

ABN

ACN

Postal address *

Suburb/Town *

State *

Postcode *

EmailIf no email address, please type no@email.com

Contact phone number *

Are there any other lessees? *

YesNo

Please complete an Additional applicants form and save it to your desktop/USB, etc. Click Browse below and locate the saved form to upload it to this application.

Additional applicants form upload

Browse

Additional details

Please add any other information relevant to this application.

Locate attachments on your desktop/USB, etc. and click Browse below to upload them to this application.

Browse

Declaration

Full name of person submitting this form *

Email address *

Date *

I declare that the information stated within this application is true and correct *

I acknowledge that neither the Minister nor any agent or employee of the Minister makes any representation with regard to the use or permitted use of the Land (whether past, present or future) should this application be approved. *

I acknowledge that I am/the lessee is required to undertake my/their own investigations with the relevant authorities regarding the intended use of the land should this application be approved. *

Payment details

BpointPayment *

Receipt Number

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