LUAO/

L Passport
GENERAL Size
Photograph
LAGOS STATE GOVERNMENT OF NIGERIA
APPLICATION FOR ALLOCATION OF STATE LAND
(LAND USE DECREE No. 6 OF 1978)

1. Name……………………………………………………………………………………………………….
(In full, Surname in Capitals)

2. Address (a) Business……………………………………………………………………………………….

(b) Home………………………………………………………………………………………….
(Not P.O Box)

3. Nationality and How Acquired……………………………………….……………………………………..

4. Occupation or Nature Of Business………………………………….………………………………………

**5. Age (not below 18 years) ………………………………………………..……..…………………………..

** 6. Annual Income and/or Salary……………………………………………………….………………………

7. Whether Applicant is owner of any State land……………………………………………….…………….

8. If the answer to 7 is the affirmative, please supply the following particulars:

(i) Where land is situated……………………………………………………………………….
(ii) When land was allocated……………………………………………………….…..………..
(iii) Whether developed or not…………………………………………………….………………
9. Whether applicant is assignor or assignee of State land……………………………………………………..

10. If the answer to 9 is in the affirmative, please furnish the following particulars:
In respect of the applicant (whether assignor or assignee)
(i) Where land is situated…………………………………………………….…………………
(ii) When land is assigned…………………………………………………………….…………
(iii) Name and last known address of assignee or assignor………………………….…………..
(iv) Whether land is developed or not……………………………………………………………
11. Type of Plots required: (i) Residential……………………………………………………………….
(ii) Industrial/Commercial/Agricultural……………………………………..
(iii) Civic/Religious/Charitable Purposes…………………………………….
12. If residential please indicate as appropriate the type of building proposed:
(i) Single family dwellings………………………….……………………………………………………….
( size 19.812m x 30.48m to 27.432m x 30.48m i.e. up to [Link])
(size 65ft x 100ft to 90ft x 100ft i.e. up to 9,[Link])
(ii) Block of flats………………………………………………………………………….…………………
(size 30.48m x 60.96m. i.e. more than 1,858.061sq. metres)
( size more than 100ft x 200ft i.e. more than 20,[Link])

Application fee payable for: General Lekki

(a) Residential Plot. . . . . . . . N2,500 N7,500
(b) Industrial/Commercial/Agricultural . . N7,500
( c) Civil/Religious/Charitable Plot . . . . N7,500
**Not applicable in case of Industrial/Commercial ventures
13. If a plot is allocated:
(a) How soon do you expect to develop it………………………………….…………………………..

(b) How much do you propose to invest in its development………………………………….………..

(c) How do you propose to finance the development……………………………………………………

14. Has Government acquired any property from you or your family within Lagos state?
If so,give details:
(a) Location………………………………………………………………………………………………

(b) Size………………………………………………………………………………….…………..……

(c) Date of Acquisition…………………………………………………………………………………...

(d) Acquiring Authority…………………………………………………………………………………..

(e) Whether or not compensation has been paid………………………………………………..

15. DECLARTION (To be sworn to by ALL applicants)

I…………………………………………….of……………………………………………
(Full name) (Address)

do hereby solemnly and sincerely declare and say that the information given on this application is correct to the best of
my knowledge,information and belief and I hereby solemnly undertake to surrender to the Lagos State Government
any plot of state land that may be allocated to me in response to his application if it is discovered that the information
given is not correct or if I fail or neglect to develop the said land within the time prescribed by the Government.
…………………………………
Signature/Mark of Declarant
Applicant
The foregoing having been read over to the
Illiterate Declarant/Applicant

Mr/Mrs/Miss…………………………….In

The ………………………language by the

Interpreter Mr./Mrs./Miss
When he/she seemed perfectly to understand
The purport of the same before affixing his/her
Left thumb impression.

Sworn to at……………………………………………….Registry…………………………………
This……………………………………………..day of………………………………………20….

Before Me
…………………………………………………………………………..
Commissioner for Oaths/Notary Public/Magistrate/Justice of the peace.
Notes:
(a) Applicant is required to submit:
(i) Two copies of recent passport size photographs one of which should be certified as being a true
likeness of the Applicant.
(ii) The immediate last three years tax Receipts or Tax Clearance Certificate for the last three years and
Development Levy.
(iii) Copy of Purchase Receipt.
(iv) If naturalized, particulars thereof.
(b) The declaration below paragraph 15 of this application form must be sworn to before either a
Magistrate,justice of the Peace, a commissioner for Oaths or a Notary Public and decarant/applicant should note that
falsity of this declaration may amount to a criminal offence.
(c) In case of Ratification:
(i) Copy of Land Information Certificate
(ii) Copy Of receipt for Land Information
(iii) Copy of Survey Plan and Hand Sketch of site
(iv) Copy of Land Purchase Receipt, Stamp duty.

FOR OFFICIAL USE ONLY

(A) Application Form received by: Name…………………………………………

Rank………….…………………….................

Signature…………………Date...…….20……

Station No……………………………Land Office……………………….…………….L.G.A.

Amount received……………………………N

Revenue Collector’s Receipt issued No……..………….of………….20……………..

(B) Acknowledgement Form issued: Ref. No ……………of………20............

Issued by: Name……………………………………

Rank……………………………….........

Signature…………..Date…..20………...

(C) Checked by: Name…………………………………….

Rank……………………………………..

Signature……….Date…….20…………..

(N.B. item C is to be completed by the Officer-in charge of Zonal Land Office.)