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QUEENSLAND TITLES REGISTRY                                                              COVENANT                                                           FORM 31 Version 3
Land Title Act 1994 and Land Act 1994                                                                                                                          Page 1 of 5

                                          Dealing Number                                         Lodger (Name, address, E-mail & phone number)                   Lodger
                                                                                                                                                                 Code
                                      OFFICE USE ONLY
  Privacy Statement
  Collection of information from this form is authorised by legislation and is
  used to maintain publicly searchable records. For more information see
  the Department’s website.

  1.     Covenantor




  2.     Description of Covenant / Lot on Plan                                   County                     Parish                                    Title Reference


  3.     Covenantee
         Noosa Shire Council



  4.     Description of Covenant (include reference to relevant section of legislation)
         Pursuant to Section 97A(3)(b)(i) of the Land Title Act 1994




  5.     Execution
  The Covenantor being the registered owner of the lot described in item 2 covenants with the Covenantee in respect of the covenant
  described in item 4 and the attached schedule.


                     Witnessing officer must be aware of his/her obligations under section 162 of the Land Title Act 1994


  .............................................................................. signature

  .............................................................................. full name

  .............................................................................. qualification       /    /           .....................................................................
  Witnessing Officer                                                                             Execution Date                                    Covenantor's Signature
  (Witnessing officer must be in accordance with Schedule 1
  of Land Title Act 1994 eg Legal Practitioner, JP, C Dec)


  .............................................................................. signature

  .............................................................................. full name

  .............................................................................. qualification       /    /           .....................................................................
  Witnessing Officer                                                                             Execution Date                                    Covenantee's Signature
  (Witnessing officer must be in accordance with Schedule 1
  of Land Title Act 1994 eg Legal Practitioner, JP, C Dec)




                                                                                                                                                                   Page 93 of 201
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