FMS Levy Clearance Request Form

FMS Levy Clearance Request Form
Which building or Scheme is the Transfer for?:
CHOOSE THE CORRECT OPTION BELOW:
Transferring Attorneys*
Attorneys Email Address: *
example@example.com
Attorneys Phone Number:*

Area CodePhone Number
Purchase Price*
SELLER DETAILS
Name of Seller*

SellerLast Name
Section Number*
Building*
Power of Attorney:*

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Clearance figures required until: *
PURCHASER DETAILS
Purchaser Name

1st Purchaser2nd Purchaser (if applicable)
Purchaser Email Address for statements:*
example@example.com
Contact Number*
As per CSOS please advise what the Purchaser's intention is with the property*
Will the Property be Bonded?*
Name of Bondholder*

First NameLast Name
ID of Bondholder*
FICA REQUIREMENT
FICA: ID or Statutory Documents*

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FICA: Proof of address*

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Date of registration*

MonthDayYear
Date
CONFIRMATION OF REGISTRATION
Upload confirmation

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