Lantmäteriet Fastighetsinskrivning 761 80 Norrtälje Sweden
FORM
Application for cancellation of mortgage certifi- cate
Cancellation of mortgage certificate pursuant to Section 3 of the Act on Cancellation of Lost Documents (2011:900).
Before filling in this form, please check if you can apply to cancel the mort- gage instead according to Section 20 of the same Act.
Pay application fee
In connection with the application, you must pay an applica- tion fee of SEK 500 to: Bankgiro 766-6746 or via Swish 123 073 4798, or scan the QR code with your
smartphone.
Please specify the municipality and the cadastral reference when making the payment.
We will start processing the matter when the application fee has been paid.
1. Property/Site-leasehold
Please specify the cadastral reference of the property/site-leasehold inclu- ding municipality, for example Gävle Torp 1:1
* Required fields.
Municipality: * Property/Site-leasehold (name and number): *
If the application relates to several properties, please list these in the section “8. Other Information” below.
2. Applicant
* Required fields.
Name/Company: * Email address: *
Lantmäteriet, PHONE +46 (0)771-63 63 63 EMAIL lantmateriet@lm.se WEBSITE www.lantmateriet.se Figure 1QR code
LANTMÄTERIET
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Address: * Daytime phone: *
Postal code: * Postal location: *
Name/Company: * Email address: *
Address: * Daytime phone: *
Postal code: * Postal location: *
If there are more than two owners, please specify these in section “8. Other Infor- mation” below.
3. Representative/Contact person
Recipient of notification and decision, if different from applicant.
Name/Company: E-mail:
Address: Daytime phone:
Postal code: Postal location:
4. Mortgages
*Required fields
Date on which mortgage
1 was granted: * Docket number of the mort-
gage: * Amount: *
Date on which mortgage
2 was granted: * Docket number of the mort-
gage: * Amount: *
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Are there additional mortgages that should be cancelled? Specify these with date, docket number and amount below.
5. I/We apply to cancel in my/our capacity as
☐ Property owner with title deeds or holder of site-leasehold.
☐ Previous property owner with title deeds or previous holder of site- leasehold.
☐ Lender, when I held the pledged certificate.
☐ Estate (estate owner must certify that the deceased held the mortgage certificate).
☐ Other, namely
6. Certifies possession of document *
*Required fields
☐ The applicant certifies that I/we was/were in possession of the mortgage certificate and subsequently lost it.
7. Where was the document stored? *
*Required fields
☐ In the home
☐ In another place, namely
*Describe how the document was destroyed or lost:
(For example, if the mortgage certificate was lost in connection with relocation or destroyed by fire.)
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8. Other information
9. Signature
Date
______________________________ ____________________________
Signature Signature
Name (printed) Name (printed)
ABOUT PERSONAL DATA
When Lantmäteriet collects personal data, the authority must provide infor- mation on the processing of personal data. This information is available on the website www.lantmateriet.se/personuppgifteror by contacting Customer Services on phone number 0771-63 63 63.
