Form LRA-27 (r.
43(2(b), 44(2)(f), 45(2)(e))
REPUBLIC OF KENYA
THE LAND REGISTRATION ACT
THE LAND REGISTRATION (GENERAL) REGULATIONS, 2017
Date Received Presentation Book Official Fees Paid
………………… No…………………. Kshs.
MUTATION FORM
(This form is to be completed in triplicate.)
Part A: Title Details and Registered Proprietor(s) instructions to the Surveyor
TITLE NUMBER(S):……….................................................................
Title No. Title No. Title No. Title No. Title No.
Approximate
Area
(Hectares)
Cadastral
Map Sheet
No.
Registered 1. .………………………………………………………………………….
Proprietor 2. .....………………………………………………………………………..
(s) ID 3. ...…..……………………………………………………………………..
/Passport 4. ...…………………………………………………………………………
No/Registrat 5. .…………………………………………………………………………..
ion No. and
Address
Instructions of Registered Proprietor(s) to the Surveyor*
The Proprietor(s) of the above noted Parcel(s) HEREBY instructs the Surveyor to carry out the
following (tick as appropriate):
1. Subdivide the parcel as shown on page two/as per attached approved scheme plan
2. Re-parcel the parcels noted above as shown on page two/as per attached approved scheme plan
3. Combine the parcels noted above as shown on page two/as per attached approved scheme plan.
4. Partition the parcel noted above as shown on page two/as per attached approved scheme plan.
5. Change the common boundaries of the parcels noted above as shown on page two/as per
attached approved scheme plan.
6. The boundaries are to be surveyed according to the area(s) as shown on page two/as per
attached approved scheme plan.
7. The boundaries are to be surveyed as they exist on the ground as shown on page two/as per
attached approved scheme plan.
(An Approved Scheme Plan may be attached)
Proposed Plot(s) Layout (Not to Scale)
Page Three
1. Name ………………………… ID No. …………… Signature/Thumb Print …………….
2. Name ………………………... ID No. …………… Signature/Thumb Print ……………
3. Name ………………………... ID No. …………… Signature/Thumb Print ……………
4. Name ………………………... ID No. …………… Signature/Thumb Print ……………
5. Name ……………………….. ID No. …………… Signature/Thumb Print ……………
Certificate of Verification
I CERTIFY that the above-named Proprietor(s) appeared before me on the
….……. day of ….……………… 20……. and being known to me/being identified by
…………………………………………… of ………………....................... acknowledged
the above signature(s) or mark(s) to be his/hers/theirs and that he/she/they had freely and
voluntarily executed this instrument .
*The person certifying should be a Surveyor or an Advocate of the High Court of Kenya or Licensed
Physical Planner
Part
DrawB:orDetails and Confirmation
Attach Plot(s) by the
Layout as Surveyed Surveyor
on Site – Plotted to Scale
1. I confirm that the plotting above contains the actual measurements recorded at the time of
observation in the field and certify that all the work performed in the field and in the office has
been carried out by myself / under my personal direction, and I take full responsibility for all
work so performed.
Name & Registration No. of the Surveyor: ……………………................
Signature: ………………… Official Stamp: ……………………
Date: ………………………………………
2. The Proprietor(s) confirms having been shown the boundary extent of the resultant parcel(s).
Name & ID of Proprietor(s)/Representative or Authorized Agent:………
Signature/ Thumb Print:………………………… Date: …………………
Page Four
To: The Government Surveyor: Please provide new parcel numbers to the following parcels of
land and amend the Cadastral Map accordingly:
No. of A B C D E F G H I J
Parcels
New Parcel
Number(s)
Approx.
Area (Ha)
Name & Registration No. of Surveyor: ….....................................................
Signature: …………………….. Official Stamp: …...………………………
Date…………………………………
Part C: Certification by the Government Surveyor
To the Land Registrar: …………………………………………… County
I certify that the survey and information represented by this Mutation Form Serial
No.…………………………… has been prepared in accordance with the Survey Act and Survey
Regulations. I have checked and approved the Mutation; issued new numbers to the respective
parcel(s) and amended the Cadastral Map accordingly. You may therefore register the Mutation.
A copy of the amended Cadastral Map is herewith attached.
Name of Government Surveyor: ……………...............................................
Signature: ………………………… Official Stamp: ……………………..
Date: …………………………………
Part D: Registration by the Land Registrar
REGISTERED this ….….day…………..............................20............................
Entry No…………………………………….Property Section.
Name of Land Registrar:……………………………….…………..........…….
Signature and Number of Land Registrar………………….…………………
Seal of the Land Registry......................
