RELEASE OF REGISTERED STATUTORY LAND CHARGE To the District Land Registrar, [or Registrar of Deeds,] [[or Mining Registrar,]] Land Registration District. [or Deeds Registration District.] [[or Mining District.]] I HEREBY certify that the statutory land charge hereinafter referred to has been satisfied [[or partially satisfied or is no longer claimed in respect of the part of the land described below], and you are hereby required tomake an entry in the register and (where necessary) on the outstanding instrument of title, noting that the charge is released wholly [or partially]] accordingly. DESCRIPTION OF LAND AFFECTED AND REFERENCE TO CHARGEName of proprietor: Situation: Area: Description by reference to Section number, etc: [If under Land Transfer Act] Reference to Certificate of Title: Vol ; Fol Description of charge: [Insert particulars as to amount, registered number, etc., sufficient to identify the charge.] Dated at, thisday of,19. [Name and description of person or body in whose favour the charge was created.] The words [or Mining Registrar] and [or Mining District] were inserted by s 2(5)(c) and (d) of the Statutory Land Charges Registration Amendment Act 1959. The words in the third set of bold square brackets were substituted for the words , and you are hereby required and directed to register a release of the same by s 3 of the Statutory Land Charges Registration Amendment Act 1980.